The Relationship between Pain and Disability among Candidates for Back Surgery: A Cross-Sectional Study in Erbil, 2024-2025

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Background: Back pain is a leading cause of disability globally, often requiring surgical intervention when conservative treatments fail. Therefore, this study investigates the relationship between pain and functional disability among candidates for back surgery in Erbil, Iraq, while exploring associated sociodemographic and clinical factors. Methods: This cross-sectional study was conducted at Hawler Teaching Hospital from September 2024 to March 2025. Using purposive sample, four parts of questionnaires. Pain intensity was assessed with the Universal Pain Assessment Tool (UPAT) and functional disability was measured using the Oswestry Disability Index (ODI). The data was analyzed through using SPSS, Version 27. Descriptive statistics, Pearson's correlation and multiple linear regression were used to analyze and relationship between pain and functional disability. Statistical significance was set at p<0.05. Results: The samples consisted of 103 participants, majority of them (87.4%) complaining with severe pain (Mean±SD score: 8.43±1.87) and 61.2% being completely disabled (Mean±SD score: 35.74±7.72). A moderate positive correlation was found between pain and disability levels (r = 0.30, p<0.001), A significant positive correlation was observed between pain intensity and functional disability (r = 0.30, p<0.001). A regression analysis found that disability level was the only strongly significant predictor (β = 0.99, p<0.001) of the outcome (likely pain), with higher disability linked to worse results. Conclusions: The study demonstrates a significant positive correlation between pain severity and disability levels in back surgery candidates, with disability being the strongest predictor of pain intensity while demographic and clinical factors showed no significant influence. Healthcare providers should prioritize disability assessment and management alongside traditional pain interventions, while policymakers should develop guidelines that incorporate functional improvement strategies as a primary approach to reduce pain burden in this patient population.

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