THE IMPORTANCE OF RADIATING LEG PAIN IN ASSESSING HEALTH OUTCOMES AMONG PATIENTS WITH LOW-BACK-PAIN - RESULTS FROM THE VETERANS HEALTH STUDY

Study Design. Cross-sectional data were analyzed from the: Veterans He alth Study, an observational study of patients receiving ambulatory ca re. Objective. To develop a method of stratifying patients with low ba ck pain by combining patient reports Df radiating leg pain with the re sults of straight leg raising test's. Summary and Background Data. Fou r hundred thirty-four participants with low back pain were identified through patient-reports of ever having had low back pain, of low-back pain that began more than 3 months ago, and of a health-care visit for low back pain in the past year.:four hundred twenty-eight patients wi th low back pain-were included in the current analysis. Methods. Parti cipants were mailed a health-related quality of life questionnaire and had an interview that included a low back pain questionnaire and a st raight leg raising test. Patients' reports of radiating leg pain and r esults of the straight leg raising tests were combined into four hiera rchical groups. This stratification was evaluated in relation to respo nses to the health-related quality of life questionnaire, localized lo w back pain, disability, and use of medical services. Results. The int ensity Of localized low back pain and disability increased from Group 1 (low back pain alone) to Group 4 (pain below knee with positive stra ight leg raising test result), whereas health-related quality of life decreased. Group 4 patients were 5.1 times more likely than were Group 1 patients to use medications for low back pain (95% confidence inter val 1.2, 22.9), 6.8 times more likely to have a spinal magnetic resona nce study (95% confidence interval, 2.7, 17.2), and 3.9 times more lik ely to have surgery (95% confidence interval, 1.3, Conclusions. The me thod of measuring correlation performs well in identifying patients wi th different levels of localized low back pain intensity, health-relat ed quality of life, and use of services. It may be useful in studies o f health outcomes, in clinical trials, and in predicting demands on he alth care resources.