The Role of Life Purpose in Disability and Depression in Patients with Acute Low Back Pain

Background/Purpose: Life purpose (also termed purpose in life or meaning in life) has been defined as “believing one’s actions have a set place in the larger order of things and that one’s behavior fits naturally into the course of a larger, more important social whole.” Although there is a dearth of published research on the role of life purpose in patients with acute low back pain, research in chronic pain suggests that those with chronic pain who have increased life purpose had less depression among other important health outcomes. 

Methods: We used linear regression models to describe the relationship of life purpose (Scale of Psychological Well-Being– Life Purpose subscale; range=14-84) with disability (total score, Roland Morris Disability Scale, range=0-24) and depression (total score, Center for Epidemiologic Studies Depression Scale, range=20-80) in persons with acute low back pain (healthcare provider diagnosed low back pain present for less than 3 months; N=37) participating in a randomized clinical trial to prevent transition to chronic low-back pain.

Results:   In our predominantly female sample (81.8%) with a mean age of 53 years (standard deviation =11.6 years), 52% worked full-time. Controlling for current work status (working full-time versus not), the overall model was significant for disability (R² =.16, F[2,36]=3.17; p=.05), with an adjusted R² of 0.11. Predicted disability was lower by .38 points per 1-point higher score on life purpose (p=.02). Controlling for gender (rates of depression are higher in females), the overall model was significant for depression (R² =.26, F[2,36]=6.07; p=.006), with an adjusted R² of 0.22. Predicted depression score was lower by 0.52 points per 1-point higher score on life purpose (p=.002).

Conclusion: Findings from this study suggest that life purpose has a significant association with disability (controlling for work status) and depression (controlling for gender) in this sample of persons with acute low back pain which is previously undescribed in the identified published literature. A furthered understanding of the relationship between life purpose and depression and disability could improve these important health factors in this population.