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Patients with Chronic Lower Back Pain Just as Active as People without Back Pain
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Posted on: 11/30/1999
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It used to be when someone was experiencing chronic lower back pain, they were told to rest in bed until they felt better. This chronic lower back pain occurs in up to 10 percent of people who have an acute (sudden) non-specific lower back pain. Doctors noticed, however, that patients who stayed in bed could end up with other problems because of their inactivity. This is particularly important among the elderly. Disuse of the muscles could lead to weight gain and obesity, decreased muscle strength and decreased heart function.
The researchers in this study looked at 3 separate issues regarding disuse and chronic lower back pain: 1) the development of disuse within 1 year of the onset of back pain, 2) the development of physical deconditioning within 1 year of onset of back pain, and 3) which factors may predict a change in physical activity in daily life (PAL) over the year.
One hundred twenty four patients who had acute back pain for between 4 and 7 weeks were followed for 1 year. One hundred six patients (58 males) completed the study; the average age was 46.7 years, with a range between 35.6 and 51.9 years. The researchers used the Visual Analog Scale (VAS) for rating pain, the Pain Catastrophizing Scale (PCS) for psychological concerns about further pain, the Tampa scale for kinesiophobia (TSK) for fear of movement and reinjury, and PAL was measured using a device that recorded body movements. This device was worn by the patients during the waking hours for 7 uninterrupted days.
After 1 year, 67.9 percent of the patients still complained of back pain. They were classified as "patients with CLBP." The other patients were classified as "recovered subjects." When the study started, the average level of pain intensity reported by patients with CLBP was 41 and at follow up it was 26.5 TSK was 35 at study start and 32.6 at follow up. PCS was 17 at study start, 9 at follow up. PAL was 8.4 at study start, and 8.5 at follow up. For the recovered patients, average pain intensity at study start was 31, 0 at follow up. TSK at study start was 34, 31 at follow up. PCS at study start was 14, 8 at follow up. PAL at study start was 8.4, 8.3 at follow up.
The researchers noted that there was no difference in PAL between the patients who recovered and those who did not, so their original premise that patients with back pain would have lower levels of daily physical activity was wrong. Taking the findings into account, the authors pointed out that it should not be recommended to use a patient's level of activity to determine treatment for chronic lower back pain because they could maintain the equivalent of activity to someone without pain. They concluded that there is no evidence so far that shows that patients with chronic lower back pain will suffer from disuse.
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References:
Eric J. Bousema et al. Disuse and physical deconditioning in the first year after the onset of back pain. In Pain. July 2007. Vol. 130. Pp. 278-286.
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