[Type D personality style and back pain : A narrative overview of the relevance of psychosocial factors in orthopedic pain therapy].

Background: The Type D personality ("distressed personality") is characterized by a combination of negative affectivity and social inhibition. While this personality style was originally researched in the context of cardiovascular disease, recent studies also show a significant association with chronic pain disorders, especially back pain.

Objectives: This narrative review examines the current state of knowledge on the relationship between type D personality and back pain. The aim is to analyze possible psychological, behavioral, and biological mechanisms and to derive clinical implications for orthopedic pain therapy.

Materials and methods: A selective literature search was conducted in the PubMed, PsycINFO and Google Scholar databases. Original studies, systematic reviews and meta-analyses from the last 20 years focusing on psychosomatic aspects of chronic back pain were included.

Results: Several studies show that individuals with Type D characteristics have an increased risk of developing and chronicizing back pain. Possible mediating mechanisms include maladaptive stress processing, somatisation, reduced social support and changes in neuroendocrine and inflammatory processes.

Conclusions: Type D personality is a relevant psychosocial risk factor in the development and persistence of chronic back pain. Early detection may contribute to improving multidisciplinary therapeutic approaches.