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Medical history and chronic pain
1Department of Physical Therapy, Faculty of Medicine, University of Toronto, Ontario, Canada. judith.hunter@utoronto.ca
Objective:
Can either a history of previous similar injury, including recurrence of injury, or an individual's symptoms, including time off work, predict chronic pain and/or chronic pain disability?
Methodology:
The literature search identified one systematic review and six observational studies (5 low back pain and 1 chronic shoulder pain) to provide evidence about these questions.
Results:
Only one study evaluated subjects before a painful event. Other studies evaluated subjects over a range of time from onset of pain, including some selected for clinic treatment. This variability as well as the use of different outcome measures without blinding limited the quality of the evidence.
Conclusions:
The studies provide moderate evidence (level 2) that a history of previous similar pain predicts subsequent reports of pain and limited evidence (level 3) that a history of similar pain predicts poorer outcomes after recurrent injury. The studies also provide moderate evidence (level 2) that longer duration of pain predicts the occurrence of subsequent reports of pain and limited evidence (level 3) that longer time off work before treatment predicts poorer activity and poorer participation outcomes after recurrent injury.
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