Understanding the role of positive body image in chronic low back pain: A path-analytic model

Chronic low back pain (CLBP) is a prevalent and disabling condition that significantly affects individuals' quality of life. Recently, the cognitivebehavioral model of body image and chronic pain has emphasized the influence of body image on the course of this condition. Nevertheless, the role of positive body image constructs, such as body appreciation and appreciation of body functionality, in CLBP remains underexplored. This study examined associations between body appreciation and functionality appreciation with pain intensity and interference in individuals with CLBP, with pain catastrophizing and kinesiophobia as potential mediators. A sample of 99 Spanish adults suffering from CLBP completed self-report measures. The path-analytic model showed an acceptable fit. While body appreciation showed no significant associations, functionality appreciation was negatively associated with pain catastrophizing, which in turn was positively associated with both pain intensity and interference. Indirect associations revealed that pain catastrophizing mediated the relationships between functionality appreciation and both pain outcomes. These results suggest the potential role of functionality appreciation in relation to pain outcomes in CLBP, with pain catastrophizing mediating these associations, highlighting the need for research examining whether targeting positive body image constructs, especially functionality appreciation, in pain management interventions could influence CLBP outcomes.