Low Back Pain Flares: How do They Differ From an Increase in Pain?

Area of Science:

• Pain Management
• Rehabilitation Medicine
• Psychosomatic Medicine

Background:

• Low back pain (LBP) is a common condition with fluctuating symptoms.
• The term 'flare' is often used to describe symptom exacerbations in LBP.
• Patient perception of flares may not always align with objective pain increases.

Purpose of the Study:

• To assess the correlation between self-reported flares (SRF) and pain-defined flares (PDF) in LBP patients.
• To investigate differences in physical and psychosocial features between SRF and PDF.

Main Methods:

• A case cross-over study involving 126 individuals with chronic LBP (≥3 months).
• Daily data collection for 28 days via a smartphone application.
• Assessment of flares, physical, and psychosocial features.

Main Results:

• 68% of self-reported flares (SRF) did not involve greater than average pain (PDF).
• However, 64% of days with greater than average pain were reported as SRF.
• Days with SRF, with or without PDF, showed worse physical and psychosocial features compared to non-flare days.

Conclusions:

• LBP flares encompass more than just increased pain intensity, including significant psychosocial dimensions.
• Understanding flares through a multidimensional lens is crucial for managing LBP symptom fluctuations.
• Future research and clinical approaches should consider the broader impact of flares on patients' well-being.