Prevalence of kinesiophobia in patients with inflammatory and noninflammatory low back pain and its relevance with clinical parameters

Objective: Low back pain (LBP) is defined as pain localised between the 12th rib and the inferior gluteal folds. Patients with low back pain can be divided into two large groups depending on the degree of chronic spinal inflammation. Diagnosis of noninflammatory low back pain is made by exclusion of inflammatory arthritis. AS, the most common type of spondylarthritis, is a chronic, inflammatory rheumatic disease of unknown etiology, especially involving the spine and sacroiliac joints. In recent studies, it was understood that low back pain could not be explained only by clinical findings and the disease is of physical, perceptual, social and behavioral origin. Increased perception of pain with this effect also causes kinesiophobia. Kinesiophobia is defined as an excessive, irrational and debilitating fear of physical movement and activity resulting from a feeling of vulnerability due to painful injury or reinjury. This avoidance behavior can result in immobility, leading to loss of muscle strength, depression and delayed recovery. The aim of this study is therefore to compare the prevalence of kinesiophobia in patients with inflammatory low back pain and non-inflammatory low back pain and to investigate the relationship between kinesiophobia and pain severity, depression, quality of life, functional status and disease activity. Materials and Methods: Patients between 18-40 years old who were diagnosed as non-inflammatory low back pain (n= 101) and diagnosed as AS (n= 107) according to ASAS criteria were included in the study. Kinesiophobia was assessed with TSK; quality of life was assessed with SF-36, emotional status was assessed with BDI, pain was assessed with VAS, disease activity was assessed with BASDAI, and functional status was assessed with BASFI. Findings: The prevalence of kinesiophobia (TSK>37) was found to be 57% in the AS group and 63.4% in the non-inflammatory group. There was no difference between the two groups in terms of TSK score and frequency of kinesiophobia (p>0.05). CRP and ESR values were higher in AS group than non-inflammatory group (p<0.05). No significant relationship was found between kinesiophobia and age, BMI, ESH and serum vitamin D3 in both groups (p>0.05). While there was a weakly significant relationship between kinesiophobia and CRP in the AS group (p<0.05), the same relationship was not found in the non-inflammatory group. There was a moderate relationship between TKS and BASDAI and BASFI in patients with AS (p<0.05). In both groups, TSK was positively correlated with VAS-pain and BDI, negatively correlated with SF-36 subscales (p<0.05). Results: In the study, it was found that kinesiophobia was common in patients with inflammatory and non-inflammatory low back pain. Low back pain accompanied with kinesiophobia was found to be associated with poor quality of life, depression and pain severity. AS a result, kinesiophobia should be kept in mind in the treatment of patients with low back pain and precautions should be taken to prevent complications related to immobility.