The relationship between optimism and physical health functioning in chronic low back pain and pain-free individuals

Chronic low back pain (cLBP) can interfere with daily activities and be a major contributor of worse long-term disability and overall well-being. It disproportionally impacts non-Hispanic Black (NHB) and people of lower socioeconomic status. Additionally, optimism is a trait that has been linked to reduced symptom severity, including pain and pain adjustment, as well as related to self-report measures of health and physical functioning. Few studies have assessed the joint contribution of race and optimism in relation to physical functioning for cLBP patients. In a cross-sectional sample of adults with cLBP (N=133) and pain-free adults (n=61), we assessed the role of optimism, pain, and sociodemographic factors. Participants completed the Short Physical Performance Battery, and questionnaires including study demographics, the Life Orientation Test Revised (LOT-R), and the Center for Epidemiological Studies – Depression Scale. Linear mixed-models analyses and regression-based analyses were conducted using SPSS version 26.0. There was no significant difference in optimism scores between pain-free (M = 18.2, SD = 4.6) and cLBP (M = 17.0, SD = 4.3), nor by race between NHB (M = 17.6, SD = 4.3) and non-Hispanic White (17.0, SD = 4.6). In a parsimonious linear mixed models approach adjusted for sex, age, depression, and race, findings revealed that optimism (F=4.8, p = .03, [CI: .006 to .11]), race (F = 11.1, p = .001, [CI: -1.14 to -.29]), and depressive symptoms (F = 12.5, p = .003, [CI: -.06 to -.02]) significantly affected overall physical function. Optimism has been demonstrated to be related to better psychological and physical well-being, and optimists show better pain regulation. Negatively biased expectations may impact behavioral choices such as less physical activity, resulting in poorer health, conditioning, and greater disability. Identification of optimism in individuals may help increase physical functioning by adjusting individual experiences. Sources of Funding: This work was supported by Examining Racial And SocioEconomic Disparities in cLBP; ERASED; R01MD010441.