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Temporal stability of self-reported visual back pain trajectories.
Casper Glissmann Nim1,2, Alice Kongsted3,4, Aron Downie5
1Medical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern, Odense, Denmark.
Pain
|April 25, 2022
Summary
Most individuals with low back pain (LBP) report stable pain trajectories over one year, though transitions to similar patterns can occur. Changes in self-reported visual pain trajectories (SRVTs) correlate with altered pain and disability levels.
Area of Science:
- Pain research
- Musculoskeletal health
- Patient-reported outcomes
Background:
- Low back pain (LBP) exhibits diverse trajectories, with patients often self-identifying their pain patterns.
- Self-reported visual pain trajectories (SRVTs) can enhance patient-provider communication regarding LBP.
- Evidence on the long-term stability of these perceived pain trajectories is limited.
Purpose of the Study:
- To assess the temporal stability of SRVTs over one year, focusing on pain intensity and course patterns.
- To investigate the association between transitions between SRVTs and subsequent changes in pain and disability.
Main Methods:
- Utilized prospective data from two primary care cohorts: the Danish Chiropractic LBP Cohort (n=1323) and the GLA:D Back cohort (n=1135).
- Participants identified one of eight SRVTs at baseline and 12-month follow-up, assessing pain intensity and pattern.
- Temporal stability was measured using stability and preference odds ratios; associations with clinical outcomes were examined.
Main Results:
- Approximately 30% of participants remained in the same SRVT after 12 months, with stability odds ratios consistently above 1.
- Transitions between SRVTs primarily occurred between patterns differing in only one subscale (intensity or pattern).
- Shifts to SRVTs indicating less or more intense pain were associated with expected changes in clinical outcomes.
Conclusions:
- While many individuals perceive their low back pain trajectories as stable over one year, there is a notable potential for change.
- Transitions between similar SRVTs are common and associated with meaningful changes in pain and disability.
- SRVTs offer a valuable tool for understanding patient experiences and monitoring treatment response in LBP.
