Rw. Mcgorry et al., The relation between pain intensity, disability, and the episodic nature of chronic and recurrent low back pain, SPINE, 25(7), 2000, pp. 834-840
Study Design. An observational study on the course of chronic and recurrent
low back pain and its relation to disability and medication use performed
on the basis of daily diary recording.
Objectives. To provide a description of daily pain reporting by individuals
with self-reported chronic and recurrent low back pain, to study how the i
ntensity and episodic nature of low back pain is related to disability and
medication use, and to classify subjects according to Von Korff's categorie
s of chronic low back pain.
Summary of Background Data. The natural history of low back pain has been d
escribed, and some classification schemes have been proposed, but little ha
s been reported on pain characteristics and their relation to self-report o
f disability.
Methods. Daily self-reports of pain intensity, social and work disability,
and medication use were collected from 94 participants with self-reported c
hronic or recurrent low back pain over a 6-month period. A metric for descr
ibing the episodic nature of chronic low back pain was developed.
Results. A significant effect of pain intensity on disability was found. Du
ring an episode, participants had significantly greater disability and medi
cation use. Work-related disability and medication use was significantly gr
eater in the latter half of an episode.
Conclusions. Pain intensity can affect disability, but the episodic nature
of low back pain also affects the ability to function in both work and pers
onal life. Intermittent increases in pain can markedly alter disability. Ch
ronic low back pain should not be treated as a static phenomenon.