All ETDs from UAB

Advisory Committee Chair

Zina Trost

Advisory Committee Members

Burel Goodin

Drew Sturgeon

Document Type


Date of Award


Degree Name by School

Master of Arts (MA) College of Arts and Sciences


Chronic low back pain (CLBP) is among the most disabling, costly, and painful conditions worldwide. In the United States, there is consistent evidence that the burden of chronic pain and associated disability disproportionately affect non-Hispanic Blacks (“Blacks”) compared to non-Hispanic Whites (“Whites”), with Blacks reporting greater pain frequency, severity, and disability. Moreover, emerging evidence suggests that perceptions of injustice related to personal pain or injury is a crucial risk factor for poor outcomes in chronic pain, including persistent musculoskeletal pain disorders. Although racial differences have been reported for multiple chronic pain conditions, relatively minimal attention has been given to potential racial differences in CLBP or pain-related injustice perception. The current study addressed the possible interplay between race, CLBP, and pain-related perceived injustice by examining potential differences in pain-related outcomes – specifically, pain severity, disability, and depression – as well as pain-related injustice perception among community-dwelling individuals with CLBP who identified as either Black or White. In addition, given the role of injustice-related factors in racial health disparities, the study further examined whether pain-related perceived injustice mediates any observed racial disparities in CLBP outcomes. Results indicated that Blacks reported significantly greater pain severity, depressive symptoms, and level of disability than White counterparts. When adjusting for relevant demographic, psychosocial, and pain variables, perceived injustice did not mediate the relationship between race and pain intensity. However, in a regression-based model adjusted for relevant variables, perceived injustice mediated the relationship between race and disability. Analyses further suggested potential mediation pathways for the relationship between race and depression. Findings from this study reinforce the importance of further examining injustice appraisals as a target for CLBP intervention.



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