The clinical course of neck pain: Are trajectory patterns stable over a 1‐year period?

Irgens, Pernille; Myhrvold, Birgitte Lawaetz; Kongsted, Alice; Waagan, K.; Engebretsen, Kaia Beck; Vøllestad, Nina Køpke; Robinson, Hilde Stendal

doi:10.1002/ejp.1879

Cited by 7 publications

(10 citation statements)

References 54 publications

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“…There are several possible explanations for these similarities. First, previous studies show that steady pain with minimal fluctuations is rare [ 13 , 17 ], and a large group of patients with episodic pain report painful episodes lasting longer than 3 months [ 19 ]. Second, patients consider pain intensity ≤ 3 on NRS as a satisfactory state [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…We described the patients’ clinical course, using the same criteria as in recently published articles [ 13 , 17 , 19 ]. Patients were classified into patterns based on pain intensity from the weekly SMS data collected over 1 year (hereafter ‘SMS-based pattern’).…”

Section: Methodsmentioning

confidence: 99%

“…We have previously found that patients in an episodic pain course have large individual and group variations in painful- and pain-free periods [ 19 ]. We therefore wanted to explore the relationship between the stability of the patients’ SMS-based pattern over 1 year and their selected visual trajectory.…”

Section: Methodsmentioning

confidence: 99%

“…We therefore used the above-mentioned classification procedure on data from two shorter periods: the first and the last quarter (weeks 1–13 and weeks 40–52, respectively) of the follow-up year. We defined patients allocated to the same pattern in the first and last quarter as having a stable trajectory, and those with different patterns as having a shifting trajectory, as done previously [ 19 ]. We calculated the proportion of patients that had a stable pattern.…”

Section: Methodsmentioning

confidence: 99%

“…Trajectories appear to be stable over time [ 18 , 19 ], as well as representing different patient profiles across various health domains [ 5 , 13 , 15 ]. Hence, it is likely they are better measures in clinical studies than single pain measures at single time-points.…”

Section: Introductionmentioning

confidence: 99%

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Exploring visual pain trajectories in neck pain patients, using clinical course, SMS-based patterns, and patient characteristics: a cohort study

et al. 2022

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Background The dynamic nature of neck pain has so far been identified through longitudinal studies with frequent measures, a method which is time-consuming and impractical. Pictures illustrating different courses of pain may be an alternative solution, usable in both clinical work and research, but it is unknown how well they capture the clinical course. The aim of this study was to explore and describe self-reported visual trajectories in terms of details of patients’ prospectively reported clinical course, their SMS-based pattern classification of neck pain, and patient’s characteristics. Methods Prospective cohort study including 888 neck pain patients from chiropractic practice, responding to weekly SMS-questions about pain intensity for 1 year from 2015 to 2017. Patients were classified into one of three clinical course patterns using definitions based on previously published descriptors. At 1-year follow-up, patients selected a visual trajectory that best represented their retrospective 1-year course of pain: single episode, episodic, mild ongoing, fluctuating and severe ongoing. Results The visual trajectories generally resembled the 1-year clinical course characteristics on group level, but there were large individual variations. Patients selecting Episodic and Mild ongoing visual trajectories were similar on most parameters. The visual trajectories generally resembled more the clinical course of the last quarter. Discussion The visual trajectories reflected the descriptors of the clinical course of pain captured by weekly SMS measures on a group level and formed groups of patients that differed on symptoms and characteristics. However, there were large variations in symptoms and characteristics within, as well as overlap between, each visual trajectory. In particular, patients with mild pain seemed predisposed to recall bias. Although the visual trajectories and SMS-based classifications appear related, visual trajectories likely capture more elements of the pain experience than just the course of pain. Therefore, they cannot be seen as a proxy for SMS-tracking of pain over 1 year.

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