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Comparing Thought and Action in Patients with Low Back Pain
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Posted on: 11/30/2003
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It is known that mental health affects patients with chronic low back pain (LBP). Unhappy or depressed patients often have a harder time getting better. They also tend to have worse disability. Doctors measure disability two ways. They ask patients to rate themselves, and they do physical tests.
These authors in the Netherlands wanted to find out how patients' self-reports matched their physical abilities. They studied 63 patients who had LBP for longer than three months. The patients answered standard questions about their health, function, and mental state. They also did a treadmill test. The treadmill test involved walking for as long as possible. Heart rate and pain were monitored while walking.
Patients receiving disability benefits reported much higher levels of pain both before and after the treadmill test. Disabled patients were much more likely to have poor mental health. The authors recommend that doctors who treat these patients should pay attention to mental health issues. However, poor mental health did not seem to be related to performance in the treadmill test. This was true even though patients with poor mental health reported that it was harder to do physical tasks. The authors aren't sure whether patients with poor mental health think they can do less than they actually can, or if depression itself makes everyday tasks too hard.
The authors conclude that questions about activities and physical tests are both important. They seem to give information on different types of symptoms and pain.
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References:
Harriėt Wittink, PhD, PT, et al. Physical Functioning: Self-Report and Performance Measures Are Related but Distinct. In Spine. October 15, 2003. Vol. 28. No. 20. Pp. 2407-2413.
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