British Verify Use of American Method of Predicting Chronic Low Back Pain

When a new method of testing patients is developed, it's not adopted for use everywhere until it's been tested and retested. In this study, a group of British (UK) researchers used a U.S. method of predicting chronic low back pain in a group of British adults.

Adults with low back pain between the ages of 30 and 59 were included. Pain severity and duration and depression were measured in the same way as in the American study. The British researchers used the same methods and cut off values to predict chronic back pain as in the American study.

Both the US and the UK studies used the Chronic Pain Grade as a tool to measure outcomes at the one-year follow-up. Results were similar between the two groups. About half of the UK subjects and slightly more than half of the US adults had chronic back pain at the end of one-year.

The main difference was that twice as many people in the UK group at low-risk had chronic pain after one year. The reason for this is unclear. It may be due to differences in the way patients are referred to their physicians between the two countries.

It may be related to when (how soon after the back pain started) the data was collected. In the US group, the patients were tested three to six weeks after they first saw their doctors. The UK group was tested one to three weeks after consultation. It may be that the proposed way to predict chronic pain is more accurate if testing is done when patients return to their doctors for more care after the first visit.

The results of this study show that testing methods used in the US healthcare system to predict chronic low back pain can be used in other healthcare systems and with other groups of people. Further study is needed to test other age groups (e.g., over age 60 years) and other population groups.

Predicting pain just on the basis of duration (how long it lasts) may not be a sensitive enough way to test patients. Duration of pain, level of pain intensity, and disability caused by pain may be more prognostic of future chronic low back pain.

Kate M. Dunn, et al. A Prognostic Approach to Defining Chronic Pain: Replication in a UK Primary Care Low Back Pain Population. In Pain. March 2008. Vol. 135. No. 1-2. Pp. 48-54.

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