The Need for Multidimensional Stratification of Chronic Low Back Pain (LBP)

نویسندگان

  • Yoga Raja Rampersaud
  • Andrew Bidos
  • Caroline Fanti
  • Anthony V. Perruccio
چکیده

MINI: The authors wanted to determine which existing primary-care low back pain stratification schema is associated with distinct subpopulations. Initial stratification by DMPP identified potentially distinct epidemiological groups. DMPP stratification resulted in discrimination beyond that provided by disability or chronicity risk stratification alone. STUDY DESIGN A cross-sectional study of Canadian patients suffering from low back pain (LBP) seeking primary care. OBJECTIVE The aim of this study was to determine which existing primary care LBP stratification schema is associated with distinct subpopulations as characterized by easily identifiable primary epidemiological factors. SUMMARY OF BACKGROUND DATA LBP is among the most frequent reasons for visits to primary care physicians and a leading cause of years lived with disability. In an effort to improve treatment response/outcomes in LBP primary care, different classification systems have been proposed in an effort to provide more tailored treatment with the intent of improving outcomes. Group-specific risk factors and underlying etiology might suggest a need for, or inform, changes to treatment approaches to optimize LBP outcomes. METHODS Stratification by dominant mechanical pain patterns; chronicity risk; disability severity. Multinomial logistic regression was used to identify the system showing greatest variability in associations with age, sex, obesity, and comorbidity. Once identified, the remaining schemas were incorporated into the model. RESULTS N = 970; mean age: 50 years (range: 18-93); 56% female. Stratification by pain pattern revealed greater variability. Adjusted analysis: Increasing age was associated with greater odds of intermittent, extension-based back- or leg-dominant pain [odds ratio (OR): 1.02 and 1.06; P < 0.01]; being male with leg-dominant pain (ORs > 2; P < 0.01). Overweight/obesity was associated with extension-based leg-dominant pain (OR = 2.6; P < 0.02) and increasing comorbidity with extension-based back-dominant pain (OR = 1.3; P < 0.01). Severe disability was associated only with constant leg pain (OR = 3.9; P < 0.01), and high chronicity risk with extension-based leg-dominant pain (OR = 0.4; P = 0.03). CONCLUSION Dominant mechanical symptom stratification resulted in further discrimination of an epidemiologically distinct and a large subgroup of LBP patients not identified by disability or chronicity risk stratification alone. Findings suggest a need for primary care initiated multidimensional stratification in chronic LBP. LEVEL OF EVIDENCE 3.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Risk factors associated with low back pain in male military personnel: case-control study

Background and Aim: Low back pain (LBP) is a multidimensional disorder which is common among military personnel. It may cause disability, reduced productivity and combat readiness of forces, and increased health care costs. Therefore, the aim of this study was to assess the risk factors associated with LBP in male military personnel. Methods: This study is a case-control study of 250 military p...

متن کامل

Effectiveness of Mindfulness-Based Cognitive Therapy on Hope and Pain Beliefs of Patients With Chronic Low Back Pain

Background: Patients with Low Back Pain (LBP) suffer from physical and psychological disability. Mindfulness-Based Cognitive Therapy (MBCT) may be an effective treatment option for patients with chronic LBP, but its efficacy on hope and pain belief is uncertain. Objectives: To determine whether MBCT could increase hope and be effective in pain beliefs in patients with LBP. Materials & Methods...

متن کامل

Effectiveness of Kinesiotaping and Conventional Physiotherapy on Patients With Non-Specific Chronic Low Back Pain

Purpose: Low Back Pain (LBP) is among the most common reasons of medical visits worldwide. It can cause limited movements, long lasting disability, and low quality of life and work. Thus, studying the efficacy of conservative treatment strategies to help patients with LBP is very important. The present study aimed to evaluate the effect of kinesiotaping in addition to conventional physiotherapy...

متن کامل

The effect of physical and psychosocial occupational factors on the chronicity of low back pain in the workers of Iranian metal industry: a cohort study

Background: Low back pain (LBP) is one of the most common problems among the workers of different industries. The role of occupational factors in causing the LBP has been indicated previously. LBP has great socio-economic costs and most of its costs are related to the chronic LBP. The aim of this study was to identify the occupational risk factors that are related to the progression of the ...

متن کامل

Effect of exercise on pain, lumbar lordosis angle and movement control in participants with non-specific chronic low back pain: a narrative review

Background and Aim: Non-specific chronic low back pain (LBP) is the most common problem of spinal column disorder and musculoskeletal problems. Many evidence has demonstrated that exercise and corrective exercise is a positive intervention on decrease pain; but according to the relationship between increased lumbar lordosis angle and low back pain; it seems to be very important to implement the...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 42  شماره 

صفحات  -

تاریخ انتشار 2017