Background and Purpose

Chronic low back pain is a medical entity in its own right that requires a biopsychosocial and not just biomedical approach. This work aims to assess the need for psychotherapy in chronic low back pain patients followed in physiotherapy in Cotonou.

Relevance:

The data on the psychotherapy needs of patients with chronic lumbar pain are important elements on which several therapeutic protocols would be based for a holistic management of the patient.

Participants / Subjects:

Forty-nine (49) patients referred by physicians and followed in the rehabilitation department of the Saint-Luc Hospital from August 1, 2017 to November 30, 2017 for chronic lumbar pain without medical-surgical and who met the inclusion criteria

Methods:

This is a prospective cross-sectional descriptive and comparative study that spans four months (August - December 2017). Upon hospital authorization, patients were informed and informed consent was received from each of them. Then they underwent physiological diagnostic examination afterward, each of them was asked to fill the Hospital Anxiety and Depression Scale (HAD) of Zigmond and Snaith (1983) which has 14 items (Rate 0 to 3 ie a maximum of 21) of which 7 to assess anxiety and 7 to assess depression.

Analysis:

The data was entered in the Excel version 2013 software, then checked and analyzed in the SPSS 20 software. The qualitative variables were presented as a percentage and the quantitative variables as the mean ± standard deviation. The Ki-2 statistical test was used to determine the factors associated with psychotherapy needs. Significant values were set at p≤0.05..

Results:

The average age is 48.92 ± 10.78; the modal class of 40 to 60 years; 73.5% are female. Low back pain lasts more than one year in 69.38% of subjects and is linked to a cultural cause in 81.64% of cases. However psychological trauma is found in 34.70% of cases. Our data also indicate that pain was severe in 71.6% of patients in the initial assessment and that 63% of patients took 4-6 different medications several times a day. Depression and anxiety were found to be 79.60% and 77.55%, respectively (score 11 to 21); 16.3% of the participants practiced at least two religions at once and 42.9% have already changed religions twice (1 to 4 times). Marital harmony was significantly disrupted (X² = 23.84, ddl = 10, p=0.008) in about one in two patients (48.9%). This disturbance was not related to the female or male gender of the subject (X² = 1.016, ddl = 2; p = 0.60).

Conclusion

The psychological care needs are very numerous in patients with chronic low back pain. Special attention should be paid to these patients during treatment.

Keywords: chronic lumbar pain; anxiety; depression; psychotherapy