Blog | Friday, February 8, 2013

QD: News Every Day--Simple screening question can tip off that lower back pain impairs other functions

A single screening question about lower back pain can guide physicians' thinking about other health-related functions, such as disability and workers' productivity, a cross-sectional observational study reported.

To evaluate the association of the severity of patient-reported chronic lower back pain with other outcomes, patients answered the question "Please rate how your chronic lower back pain condition is today" with responses of "mild," "moderate," and "severe." The responses were compared with patients' self-reported measures of pain, pain interference, health status, functional disability, work productivity, and satisfaction with medications for treating chronic lower back pain.

Results appeared in the February issue of the Journal of Spinal Disorders & Techniques.

Physicians provided records for 11 consecutive patients presenting with chronic lower back pain, totaling 1,860 subjects, of whom 1,363 (73.3%) agreed to complete the survey. Patients rated chronic lower back pain severity was rated as mild (28.6%), moderate (53.3%) and severe (18.2%).

As chronic lower back pain became more severe, significant differences were seen in increased pain (P less than 0.0001), pain interference with function (P less than 0.0001), and impairment while working due to chronic lower back pain (P less than 0.01), mainly due to presenteeism, defined as being impaired by pain at work. Increased work impairment resulted in more lost work productivity; estimated to cost per worker on an annual basis $7,080 for mild severity, $16,616 for moderate severity and $25,032 for severe chronic lower back pain. Patient satisfaction with pain medication was inversely associated with severity.

Researchers noted that in the clinical setting, patient-reported chronic lower back pain severity provides an accurate indicator of patient-reported health status and could guide pain management strategies.

Researchers wrote, "A simpler approach that may be more relevant for the daily clinical management of patients with CLBP (chronic lower back pain) is asking the patients to self-rate their disease. This study suggests the feasibility of such an approach by showing that patients, who reported their disease severity as mild, moderate, or severe, in response to a single question, also reported correspondingly greater levels of pain, pain interference with daily activities, and reductions in work productivity and health status."