Adaptive interoceptive sensibility and its predictive role in pain-related disability in people with chronic spinal pain

Abstract

Background

Identifying determinants of pain-related disability in chronic spinal pain (CSP) remains a major research focus, but the role of interoceptive sensibility is underexplored.

Objective

To determine whether adaptive interoceptive sensibility uniquely predicts pain-related disability and to compare its dimensions and cognitive factors across disability severity in people with CSP.

Methods

This cross-sectional study included 108 people with CSP. Pain intensity over the previous week and during activity, pain duration, and coexisting extremity pain were recorded. The Pain Disability Index, Pain Catastrophizing Scale, Pain Beliefs Questionnaire, and Multidimensional Assessment of Interoceptive Awareness (MAIA-2) were administered. A linear regression identified disability-related factors. Demographic-adjusted outcomes were compared across mild, moderate, and severe disability groups.

Results

Interoceptive sensibility explained an additional 17.70% of the variance in pain-related disability after adjusting for demographics, and among the eight dimensions measured by MAIA-2, not-distracting (B = −2.66, 95% CI = −5.13 to −0.18) and not-worrying (B = −6, 95% CI = −9.08 to −2.94) predicted pain-related disability (p < 0.05). Not-distracting remained a unique predictor when pain characteristics and catastrophizing were included in the model (B = −2.62, 95% CI = −4.41 to −0.83, p < 0.05). The mild disability group showed less catastrophizing and more not-worrying, and the severe disability group showed less not-distracting (p < 0.05, η²_p=0.06 to 0.19).

Conclusion

Adaptive interoceptive sensibility, especially not-worrying and not-distracting dimensions, were associated with spinal pain-related disability.