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Back pain in primary care. Outcomes at 1 year
M Von Korff1, R A Deyo, D Cherkin
1Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington.
Spine
|June 1, 1993
Summary
Most back pain patients experience persistent pain a year after care. Poor outcomes are linked to disability and pain duration, not recent onset. Depression improves with good functional outcomes.
Area of Science:
- Primary Care
- Pain Management
- Clinical Outcomes
Background:
- Back pain is a common primary care complaint with variable long-term outcomes.
- Understanding predictors of poor outcomes is crucial for effective patient management.
- Distinguishing between recent and nonrecent onset may not fully capture patient trajectories.
Purpose of the Study:
- To evaluate 1-year outcomes for primary care back pain patients.
- To identify predictors of poor functional outcomes and persistent high-intensity pain.
- To examine the relationship between depressive symptoms and back pain outcomes.
Main Methods:
- A cohort of 1128 primary care back pain patients was followed for 1 year.
- Data collected included pain onset, functional status, pain intensity, and depressive symptoms.
- Statistical analysis identified predictors of poor outcomes.
Main Results:
- A majority of patients (recent and nonrecent onset) reported persistent back pain at 1 year.
- Significant minorities experienced poor functional outcomes (14-21%) or high-intensity pain (10-16%).
- Pain-related disability, pain duration, lower education, and female gender predicted poor outcomes.
Conclusions:
- Back pain outcomes at 1 year are characterized by persistence rather than recency of onset.
- Pain-related disability and duration are stronger predictors of outcome than acute vs. chronic classification.
- Improvement in depressive symptoms is associated with good functional outcomes in persistent pain patients.