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Treating chronic low back pain. II. Long-term follow-up
David L McArthur1, Michael J Cohen, Harold J Gottlieb
1Behavioral Medicine Research, Veterans Administration Medical Center, Long Beach, CA 90822 U.S.A. Comprehensive Back Services, Casa Colina Hospital for Rehabilitative Medicine, Pomona, CA 91767 U.S.A. Department of Psychology, California State University, Los Angeles, CA U.S.A. Veterans Administration Medical Center, Sepulveda, CA 91343 U.S.A.
Abstract:
Appraisal of chronic low back pain (CLBP) treatment outcome is incomplete unless results can be shown to be stable over an extended follow-up period. This paper concentrates on methods by which the long-term trends of objective outcome assessments can be studied and predictions developed given incomplete data. Employment and litigation status, self-rating of pain, activities, medications, and hospitalizations related to pain were periodically assessed in up to 210 graduates of a CLBP treatment program, over a period of 6 months to 5 years following treatment. Favorable outcomes were achieved by many of the respondents, and a good degree of stability in outcomes was observed in several of the measures. Few indicators were found which adequately predict long-term outcomes, however. Attrition in the sample and other possible systematic sources of bias are discussed.