The treatment lottery of chronic back pain? A case series at a multidisciplinary pain centre. 2023

Anna Mattsson, and Nazdar Ghafouri, and Emmanuel Bäckryd
Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.

Despite the number of people affected by chronic back pain, and the many available treatment options, even the best modalities provide limited pain reduction on a group level, often without simultaneous improvements in functioning or health-related quality of life. The objective was to provide an overview of the treatment of chronic back pain in clinical practice at a multidisciplinary pain centre, and to study patient and pain characteristics in different treatment groups. 104 chronic back pain patients (primary ICD-10-SE-diagnosis M53.0-M54.9 excluding M54.1 and M54.3), referred to the Pain and Rehabilitation Centre, University Hospital, Linköping in 2015, were studied using data from the Swedish Quality Registry for Pain Rehabilitation, self-reported medication data, and a retrospective medical record review. The following treatment groups were identified: rehabilitation (n=21), analgesics (n=33), invasive intervention (n=14), and no treatment (n=35). Significant differences between groups were found with regards to age, sick leave, education level, persisting pain duration, punishing responses by significant other, previous invasive intervention, receiving sub-clinic, physician speciality and referring care level. Overall, patient demographics were associated with treatment strategy to a higher degree than patient-reported outcome measures. Moreover, physician speciality and organisational factors seemed to play a role in treatment choice.

UI MeSH Term Description Entries
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001416 Back Pain Acute or chronic pain located in the posterior regions of the THORAX; LUMBOSACRAL REGION; or the adjacent regions. Backache,Back Ache,Back Pain with Radiation,Back Pain without Radiation,Vertebrogenic Pain Syndrome,Ache, Back,Aches, Back,Back Aches,Back Pains,Backaches,Pain Syndrome, Vertebrogenic,Pain Syndromes, Vertebrogenic,Pain, Back,Pains, Back,Syndrome, Vertebrogenic Pain,Syndromes, Vertebrogenic Pain,Vertebrogenic Pain Syndromes
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D017116 Low Back Pain Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous SPRAINS AND STRAINS; INTERVERTEBRAL DISK DISPLACEMENT; and other conditions. Lumbago,Low Back Ache,Low Back Pain, Mechanical,Low Back Pain, Posterior Compartment,Low Back Pain, Postural,Low Back Pain, Recurrent,Low Backache,Lower Back Pain,Mechanical Low Back Pain,Postural Low Back Pain,Recurrent Low Back Pain,Ache, Low Back,Aches, Low Back,Back Ache, Low,Back Aches, Low,Back Pain, Low,Back Pain, Lower,Back Pains, Low,Back Pains, Lower,Backache, Low,Backaches, Low,Low Back Aches,Low Back Pains,Low Backaches,Lower Back Pains,Pain, Low Back,Pain, Lower Back,Pains, Low Back,Pains, Lower Back
D018710 Pain Clinics Facilities providing diagnostic, therapeutic, and palliative services for patients with severe chronic pain. These may be free-standing clinics or hospital-based and serve ambulatory or inpatient populations. The approach is usually multidisciplinary. These clinics are often referred to as "acute pain services". (From Br Med Bull 1991 Jul;47(3):762-85) Acute Pain Service,Multidisciplinary Pain Centers,Pain Centers,Pain Relief Units,Multidisciplinary Pain Clinics,Pain Service, Acute,Acute Pain Services,Center, Multidisciplinary Pain,Center, Pain,Centers, Multidisciplinary Pain,Centers, Pain,Clinic, Multidisciplinary Pain,Clinic, Pain,Clinics, Multidisciplinary Pain,Clinics, Pain,Multidisciplinary Pain Center,Multidisciplinary Pain Clinic,Pain Center,Pain Center, Multidisciplinary,Pain Centers, Multidisciplinary,Pain Clinic,Pain Clinic, Multidisciplinary,Pain Clinics, Multidisciplinary,Pain Relief Unit,Pain Services, Acute,Service, Acute Pain,Services, Acute Pain,Unit, Pain Relief,Units, Pain Relief

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