Pain, disability, and satisfation outcomes and predictors of outcomes: A practice-based study of chronic low back pain patients attending primary care and chiropractic physicians

Nyiendo, J

doi:10.1067/mmt.2001.117091

Cited by 18 publications

(20 citation statements)

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“…Depression was assessed with a 3-item screen associated with the health status questionnaire [46]. Participants were classified as having “other comorbidity,” a predictor of pain outcomes [47,48], if they checked any from the following list: arthritis, asthma or allergies, GI problems, gynecological problems, hypertension, or other chronic condition. Treatment credibility was evaluated with 6-point Likert scales on participant confidence in the 2 interventions’ success from Interstudy’s Low Back Pain TyPE Specification instrument [49].…”

Section: Methodsmentioning

confidence: 99%

Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial

Spegman²,

et al. 2010

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Section: Methodsmentioning

confidence: 99%

Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial

Spegman²,

et al. 2010

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“…Traditional non-physical treatment approaches used by chiropractors include counselling, ergonomic and other advice [5], plus the alleviation of stress [6]. Chiropractic researchers, however, have tended to use mainly severity measures to predict poor outcomes [7] and calls for deeper understanding of these issues have been made from within this research community [8-10]. If chiropractors had access to information about the role of psychosocial risk factors in their patients, they may be able to develop better targeted and justified treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial factors and their predictive value in chiropractic patients with low back pain: a prospective inception cohort study

Langworthy

Breen

2007

Chiropr Man Therap

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BackgroundBeing able to estimate the likelihood of poor recovery from episodes of back pain is important for care. Studies of psychosocial factors in inception cohorts in general practice and occupational populations have begun to make inroads to these problems. However, no studies have yet investigated this in chiropractic patients.MethodsA prospective inception cohort study of patients presenting to a UK chiropractic practice for new episodes of non-specific low back pain (LBP) was conducted. Baseline questionnaires asked about age, gender, occupation, work status, duration of current episode, chronicity, aggravating features and bothersomeness using Deyo's 'Core Set'. Psychological factors (fear-avoidance beliefs, inevitability, anxiety/distress and coping, and co-morbidity were also assessed at baseline. Satisfaction with care, number of attendances and pain impact were determined at 6 weeks. Predictors of poor outcome were sought by the calculation of relative risk ratios.ResultsMost patients presented within 4 weeks of onset. Of 158 eligible and willing patients, 130 completed both baseline and 6-week follow-up questionnaires. Greatest improvements at 6 weeks were in interference with normal work (ES 1.12) and LBP bothersomeness (ES 1.37). Although most patients began with moderate-high back pain bothersomeness scores, few had high psychometric ones. Co-morbidity was a risk for high-moderate interference with normal work at 6 weeks (RR 2.37; 95% C.I. 1.15–4.74). An episode duration of >4 weeks was associated with moderate to high bothersomeness at 6 weeks (RR 2.07; 95% C.I. 1.19 – 3.38) and negative outlook (inevitability) with moderate to high interference with normal work (RR 2.56; 95% C.I. 1.08 – 5.08).ConclusionPatients attending a private UK chiropractic clinic for new episodes of non-specific LBP exhibited few psychosocial predictors of poor outcome, unlike other patient populations that have been studied. Despite considerable bothersomeness at baseline, scores were low at follow-up. In this independent health sector back pain population, general health and duration of episode before consulting appeared more important to outcome than psychosocial factors.

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“…The results of chiropractic treatment of 526 patients with chronic low back pain with radiation below the knees were recorded in a prospective, longitudinal observational study [27]. The study concluded that patient outcomes were significantly better (using a Visual Analog Scale score [28]) for pain at periods of 6 and 12 months compared to those recorded in a group of 309 patients treated by medical practitioners.…”

Section: Resultsmentioning

confidence: 99%

“…The study concluded that patient outcomes were significantly better (using a Visual Analog Scale score [28]) for pain at periods of 6 and 12 months compared to those recorded in a group of 309 patients treated by medical practitioners. Depression notably, was a predictor of a poorer outcome within both groups [27]. …”

Section: Resultsmentioning

confidence: 99%

Are chronic low back pain outcomes improved with co-management of concurrent depression?

Middleton¹,

Pollard

2005

Chiropr Man Therap

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ObjectiveTo discuss the role of depression in chronic lower back pain and comment on appropriate methods of screening and co-management.Data SourcesThe current scientific literature was investigated using the online web databases CINAHL, Medline/PUBMED, Proquest, Meditext and from manual library searches.Data ExtractionDatabases were searched from 1980 to the present (2005). Articles were searched with the key words "depression" and "low back pain". Over three hundred articles were sourced and articles were then selected on their relevance to the chronic spinal pain states that present to manual therapy practitioners.Data synthesisPain is a subjective awareness of peripheral nociceptive stimulation, projected from the thalamus to the cerebral cortex with each individual's pain experience being mediated by his or her psychological state. Thus a psychological component will often be associated with any painful experience. A number of studies suggest (among other things) that the incidence of depression predicts chronicity in lower back pain syndromes but that chronic lower back pain does not have the reciprocal action to predict depression.ConclusionThe aetiology of chronic pain is multifactorial. There is sufficient evidence in the literature to demonstrate a requirement to draw treatment options from many sources in order to achieve a favourable pain relief outcome. The treatment should be multimodal, including mental and emotional support, counseling and herbal advice. While a strong correlation between depression and chronic low back pain can be demonstrated, an apparent paucity of literature that specifically addresses the patient response to chiropractic treatment and concurrent psychotherapy identifies the need for prospective studies of this nature to be undertaken. It is likely that multimodal/multidisciplinary treatment approaches should be encouraged to deal with these chronic lower back pain syndromes.

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Pain, disability, and satisfation outcomes and predictors of outcomes: A practice-based study of chronic low back pain patients attending primary care and chiropractic physicians

Cited by 18 publications

References 0 publications

Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial

Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial

Psychosocial factors and their predictive value in chiropractic patients with low back pain: a prospective inception cohort study

Are chronic low back pain outcomes improved with co-management of concurrent depression?

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