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The Constellation of Chronic Low Back Pain and Other Subjective Symptoms: Does the View Differ From China?
Ernest Volinn1, Bangxiang Yang, Nan Chen
1*University of Utah, Departments of Anesthesiology and Sociology, Pain Research Center, Salt Lake City, UT †Pain Management Department, West China Hospital, Sichuan University, Chengdu, PRC ‡Department of Medical Statistics, West China School of Public Health, Sichuan University, Chengdu, PRC §Department of Internal Medicine, University of Utah, Salt Lake City, UT ¶Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, PRC ||Department of Pediatrics, University of Utah, Salt Lake City, UT.
Study Design:
This was a pilot, cross-sectional study. Its site was West China Hospital in Chengdu, Sichuan Province.
Objective:
An objective was to explore whether, in China, chronic low back pain (cLBP) characteristically is one symptom among co-occurring subjective symptoms. More basic objectives were to test a supplemented list of symptoms and to reconfigure findings from the literature on co-occurrence of symptoms so that they pertain specifically to cLBP. The governing metaphor was a constellation of symptoms in which cLBP is located.
Summary Of Background Data:
With the exception of small, isolated societies, previous studies of co-occurrence of symptoms were conducted in the affluent West. Although China's population is larger than the combined populations of affluent countries of the West, research on co-occurring symptoms has been neglected in China. Unknown is whether results from studies conducted in the affluent West may be extended to China.
Methods:
A survey with the supplemented symptom list was cross-culturally adapted into Chinese and administered to cLBP patients (N = 72) and normal controls (N = 102). Multiple regression analysis was used to determine the effects of covariates (age, gender, education) on symptom reporting.
Results:
cLBP patients reported higher median numbers of symptoms than normal controls, including total symptoms (9 vs. 3), musculoskeletal symptoms (4 vs. 1), and nonmusculoskeletal symptoms (6 vs. 2.5); differences between cLBP and normal controls were highly significant (p < 0.001). Covariates had a little effect on symptom reporting.
Conclusion:
cLBP characteristically was one symptom in a constellation of symptoms. This finding came from one research site in China. Nevertheless, consistency between studies is notable, with findings from the affluent West supporting the finding from the Chinese site. The tendency to concentrate on a discrete clinical entity, cLBP itself, may obscure the constellation of symptoms. The more expansive view of cLBP has implications for clinical practice and research.
Level Of Evidence:
N/A.
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