The Impact of Sociodemographic Factors on Pain Resilience among Adults with Chronic Low Back Pain

Much chronic pain research is focused on psychosocial risk factors, but examination of the potential protective role of positive and adaptive factors, like pain resiliency, is critical. The purpose of this study was to investigate the impact of sociodemographic factors (i.e., racialized group) on pain resilience in adults with chronic low back pain (cLBP). Adults (n=192; 114 Black, 78 White, 109 female, 83 male, 45.5 ± 14.5 years of age) with cLBP completed questionnaires on pain resilience and overall pain and disability. To assess acute pain responses, participants completed a QST battery on multiple body sites, including the lower back. Overall, greater behavioral perseverance (a component of pain resilience) was significantly associated with less pain-related disability, shorter pain duration, less pain severity and interference, and less temporal summation of punctate mechanical pain on the lower back. Greater behavioral perseverance was also significantly associated with greater physical function, optimism, degree of financial security, and standard of living satisfaction. After analyzing the data by race, it was revealed that the significant associations of behavioral perseverance and pain duration, temporal summation, financial security, and standard of living were primarily driven by Black participants, not White. The relationships between behavioral perseverance and contributors to the cLBP experience appear to be racially dependent. It remains unclear whether aspects of pain resilience are shaped by various sociodemographic factors or vice versa, but identifying differences between racial groups living with chronic pain could help guide personalized therapeutic approaches for more positive biopsychological outcomes.