Efficacy of Pain Management Program for Patients with Chronic Low Back Pain -Examination of Factors Affecting Subjective Improvement-

Abstract

Introduction: Factors affecting program efficacy and subjective improvement in patients with chronic low back pain who participated in an outpatient pain management program combining education and exercise were investigated.

Methods: The subjects were 83 participants in this program who had chronic low back pain lasting more than 3 months. Education and exercise therapy were combined and conducted in small groups, one day a week, for a total of nine sessions. Before and after the program, Visual Analog Scale (VAS), Pain Disability Assessment Scale (PDAS), Hospital Anxiety and Depression scale (HADS), Pain Catastrophizing Scale (PCS), Pain Self-Efficacy Questionnaire (PSEQ), EuroQol 5 Dimension (EQ-5D), 6-min walk distance, and isometric trunk muscle strength were assessed, and subjective improvement was rated on a 7-point scale at the end of the program. The analysis consisted of 1) comparison of each evaluation item before and after the program, and 2) multiple regression analysis with subjective improvement as the dependent variable and the rate of change in other evaluation items as the independent variable.

Results: Significant improvements were observed in VAS, PDAS, HADS, PCS, PSEQ, EQ-5D, 6-min walk distance, and isometric trunk muscle strength after the program. In addition, PCS, 6-min walk distance, and EQ-5D were identified as factors affecting subjective improvement.

Conclusions: The results suggest that catastrophizing, exercise tolerance, and quality of life may have a strong effect on subjective improvement in patients with chronic low back pain.