Pain Intensity and Location May Predict Chronic Low Back Pain

Pain intensity ratings, pain location, and sensory and affective variables differ among patients who have acute low back pain (LBP) and those with chronic LBP, according to research reported in The Journal of Pain, the official journal of the American Pain Society (APS). These factors may be predictive of which patients with acute pain may then experience chronic pain.

Researchers from the Rehabilitation Institute of Chicago and Northwestern University’s Feinberg School of Medicine recruited 40 patients with acute LBP and 37 with chronic LBP to investigate differences in pain characteristics and their relationship to pain intensity. After receiving training to help them rate their pain, the patients completed questionnaires designed to assess pain intensity; medication use; and evidence of affective disorders, such as depression.

Pain intensity was significantly higher in the patients with chronic LBP. There was a higher incidence of unilateral radiating pain in patients with subacute pain; the patients with chronic pain experienced mostly bilateral pain. Of note, the depression score-considered to be attributable to pain intensity-showed just a slight increase in the patients with longer duration of pain.

The researchers concluded that pain intensity and pain location may predict chronic low back pain. They noted that there is published evidence that the location of pain in patients with acute LBP may serve as a predictor for the development of a chronic condition and that several reports indicate that patients who have subacute LBP and experience discomfort triggered by movement at distal body sites have a poorer prognosis than those in whom pain is more localized.

For more information, visit the APS Web site at http://www.ampainsoc.org. Or, contact the organization at American Pain Society, 4700 W Lake Avenue, Glenview, IL 60025; telephone: (847) 375-4715; fax: (866) 574-2654 or (847) 375-6479; international fax: (732) 460-7318; e-mail: info@ampainsoc.org. For a discussion of LBP and distal sites, see the article “Does cervical spine treatment reduce low back pain?”  on www.musculoskeletalnetwork.com.