{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:55:12Z","timestamp":1791636912631,"version":"4.3.4"},"reference-count":56,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spinal pain is a major contributor to disability, but evidence comparing multidomain outcomes across acute and chronic stages remains limited in conflict\u2010affected settings. This study aimed to compare disability, fatigue, psychological distress and sleep disturbance among patients with acute and chronic neck pain and low back pain (LBP) in the Gaza Strip.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This comparative cross\u2010sectional study included 410 adults attending outpatient physiotherapy at Nasser Medical Complex: acute neck pain (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0101), chronic neck pain (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0103), acute LBP (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0102) and chronic LBP (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0104). A 12\u2010week cut\u2010off defined acute and chronic pain. Disability was assessed using the Neck Disability Index (NDI)\/Oswestry Disability Index (ODI) scores, fatigue using the Fatigue Severity Scale (FSS), psychological distress using the Patient Health Questionnaire\u20104 (PHQ\u20104) and sleep disturbance using the PROMIS Sleep Disturbance Short Form 8a. Between\u2010group comparisons, adjusted linear regression, correlation analyses, clinical\u2010threshold analyses and logistic regression were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Chronic neck pain and chronic LBP were associated with higher disability, fatigue and psychological distress than acute pain (all primary comparisons\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Sleep disturbance did not significantly differ between the acute and chronic groups. Adjusted analyses showed that chronic pain status remained associated with higher disability, fatigue and psychological distress. Fatigue was independently associated with chronic pain status in both neck pain and LBP models. Female participants reported higher psychological distress in both pain\u2010location groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chronic spinal pain was associated with greater disability, fatigue and psychological distress but not with higher sleep disturbance. Findings support early multidimensional assessment, including screening for fatigue and psychological distress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/msc.70274","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:41:03Z","timestamp":1791636063000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disability, Fatigue and Mental Health in Acute Versus Chronic Spinal Pain in the Gaza Strip: A Comparative Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"24","author":[{"given":"Marwa","family":"Salama","sequence":"first","affiliation":[{"name":"Department of Physical Therapy Faculty of Applied Medical Sciences Al\u2010Azhar University\u2010Gaza  Gaza Gaza Strip Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Najim","sequence":"additional","affiliation":[{"name":"Department of Nursing Al\u2010Azhar 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