Clinically significant changes in pain along the Pain Intensity Numerical Rating Scale in patients with chronic low back pain

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From: PLoS ONE(Vol. 15, Issue 3)
Publisher: Public Library of Science
Document Type: Article
Length: 5,899 words
Lexile Measure: 1470L

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Abstract :

Low back pain (LBP) is the most common cause of chronic pain. Numerous clinical scales are available for evaluating pain, but their objective criteria in the management of LBP patients remain unclear. This study aimed to determine an objective cutoff value for a change in the Pain Intensity Numerical Rating Scale ([DELTA]PI-NRS) three months after LBP treatment. Its utility was compared with changes in six commonly used clinical scales in LBP patients: Pain Disability Assessment Scale (PDAS), Pain Self-Efficacy Questionnaire (PSEC), Pain Catastrophizing Scale (PCS), Athens Insomnia Scale (AIS), EuroQoL 5 Dimension (EQ5D), and Locomo 25. We included 161 LBP patients treated in two representative pain management centers. Patients were partitioned into two groups based on patient's global impression of change (PGIC) three months after treatment: satisfied (PGIC = 1, 2) and unsatisfied (3-7). Multivariate logistic regression analysis was performed to explore relevant scales in distinguishing the two groups. We found [DELTA]PI-NRS to be most closely associated with PGIC status regardless of pre-treatment pain intensity, followed by [DELTA]EQ5D, [DELTA]PDAS, [DELTA]PSEC, and [DELTA]PCS. The [DELTA]PI-NRS cutoff value for distinguishing the PGIC status was determined by ROC analysis to be 1.3-1.8 depending on pre-treatment PI-NRS, which was rounded up to [DELTA]PI-NRS = 2 for general use. Spearman's correlation coefficient revealed close relationships between [DELTA]PI-NRS and the six other clinical scales. Therefore, we determined cutoff values of these scales in distinguishing the status of [DELTA]PI-NRS[greater than or equal to]2 vs. [DELTA]PI-NRS

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Gale Document Number: GALE|A616129537