International study tries to categorize different burdens of back pain

Sep 21 2011
Researchers stretching across the globe are trying to create a comprehensive system that measures the true burden of lower back pain, taking into account factors such as psychological stress, workplace challenges and the effects one's condition has on other people.

Eighty percent of Americans will experience back pain at some point in their lives. Previous studies have characterized lower back pain as one of the biggest reasons for disability and lost wages and productivity, according to the researchers. Lower back pain may be caused by injury or degeneration of any of the physical structures of the lower spine, including the vertebrae, facet joins or the intervertebral discs that cushion the spaces between the bones. Over-activity may also hurt the muscles and ligaments in the back.

The study authors - including epidemiology and public health experts from Australia and Canada - argued that there was no existing system of measurements that encompassed all aspects of patients' lower back pain. While some approaches do consider costs and mortality, the researchers wanted a tool that also entailed things like social issues affecting the individual. To help create a new system, they gathered three focus groups in Australia and the U.S.: patients, clinicians/policy makers and multidisciplinary experts.

In order to characterize lower back pain thoroughly, the focus groups met the researchers to brainstorm statements that defined the condition's burdens. Ultimately, the researchers created a tool that divides 91 statements from their subjects into six areas of life, or domains: psychological, social, physical, treatment, employment and positive effects. Several domains also have sub-groups of statements describing the effects of lower back pain. The tool includes measurements for lower back pain that need further study, including worry about the future and discrimination by others, as reported in Arthritis Research & Therapy.

A separate study will test the researchers' new tool on 600 patients in order to get feedback and suggestions for refinement, which will lead to testing on another 600 people for further validation.

The American Academy of Orthopaedic Surgeons has several suggestions to help people avoid lower back pain. These include maintaining a healthy weight, exercises to keep the back and abdominal muscles strong, good posture and smoking cessation to halt the aging effects of nicotine.