Musculoskeletal care · 2026
Disability, Fatigue and Mental Health in Acute Versus Chronic Spinal Pain in the Gaza Strip: A Comparative Cross-Sectional Study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Salama Marwa, Najim Ahmed A, Shabana Magdy, Almukbel Reham, Mokbel Kinan
Аннотация
BACKGROUND: Spinal pain is a major contributor to disability, but evidence comparing multidomain outcomes across acute and chronic stages remains limited in conflict-affected settings. This study aimed to compare disability, fatigue, psychological distress and sleep disturbance among patients with acute and chronic neck pain and low back pain (LBP) in the Gaza Strip.
METHODS: This comparative cross-sectional study included 410 adults attending outpatient physiotherapy at Nasser Medical Complex: acute neck pain (n = 101), chronic neck pain (n = 103), acute LBP (n = 102) and chronic LBP (n = 104). A 12-week cut-off defined acute and chronic pain. Disability was assessed using the Neck Disability Index (NDI)/Oswestry Disability Index (ODI) scores, fatigue using the Fatigue Severity Scale (FSS), psychological distress using the Patient Health Questionnaire-4 (PHQ-4) and sleep disturbance using the PROMIS Sleep Disturbance Short Form 8a. Between-group comparisons, adjusted linear regression, correlation analyses, clinical-threshold analyses and logistic regression were performed.
RESULTS: Chronic neck pain and chronic LBP were associated with higher disability, fatigue and psychological distress than acute pain (all primary comparisons p < 0.001). Sleep disturbance did not significantly differ between the acute and chronic groups. Adjusted analyses showed that chronic pain status remained associated with higher disability, fatigue and psychological distress. Fatigue was independently associated with chronic pain status in both neck pain and LBP models. Female participants reported higher psychological distress in both pain-location groups.
CONCLUSIONS: Chronic spinal pain was associated with greater disability, fatigue and psychological distress but not with higher sleep disturbance. Findings support early multidimensional assessment, including screening for fatigue and psychological distress.
METHODS: This comparative cross-sectional study included 410 adults attending outpatient physiotherapy at Nasser Medical Complex: acute neck pain (n = 101), chronic neck pain (n = 103), acute LBP (n = 102) and chronic LBP (n = 104). A 12-week cut-off defined acute and chronic pain. Disability was assessed using the Neck Disability Index (NDI)/Oswestry Disability Index (ODI) scores, fatigue using the Fatigue Severity Scale (FSS), psychological distress using the Patient Health Questionnaire-4 (PHQ-4) and sleep disturbance using the PROMIS Sleep Disturbance Short Form 8a. Between-group comparisons, adjusted linear regression, correlation analyses, clinical-threshold analyses and logistic regression were performed.
RESULTS: Chronic neck pain and chronic LBP were associated with higher disability, fatigue and psychological distress than acute pain (all primary comparisons p < 0.001). Sleep disturbance did not significantly differ between the acute and chronic groups. Adjusted analyses showed that chronic pain status remained associated with higher disability, fatigue and psychological distress. Fatigue was independently associated with chronic pain status in both neck pain and LBP models. Female participants reported higher psychological distress in both pain-location groups.
CONCLUSIONS: Chronic spinal pain was associated with greater disability, fatigue and psychological distress but not with higher sleep disturbance. Findings support early multidimensional assessment, including screening for fatigue and psychological distress.