Summary: Low back pain is the most common cause of disability in adults. As many as one-fifth of adults living with low back pain. Regretfully, most people do not adequately respond to traditional drug therapy for low back pain. Therefore, researchers tried to identify the cause of poor response to the treatment. A new study shows that poor responders are people living with multiple painful conditions. Thus, when doctors only treat them for back pain, they fail to respond. In addition, these individuals have a higher prevalence of fatigue, mood disorders, sleep issues. Interestingly enough, researchers also found that the pain scale was not a good predictor for response to therapy. Thus, researchers propose physicians consider the presence of pain in other body parts in those with low back pain and decide the therapeutic approach accordingly.
People and even clinicians view chronic low back pain as a homogenous disorder. However, that is far from true. Back pain, quite like many other chronic conditions, is also associated with many other painful conditions. Furthermore, researchers think that if chronic low back pain is associated with other painful conditions, it appears to respond poorly to drug therapy.
Understanding this association between chronic low back pain and other painful conditions is essential, as many fail to respond to treatment. Therefore, the only way to treat these patients is also to identify these overlapping conditions and manage them. Chronic pain specialists play a vital role in this comprehensive approach to pain management.
Chronic low back pain is a widespread problem. Even worse, the issue of back pain and other chronic pains is increasing even in young adults. It is estimated that about one-fifth of adults aged 20 to 59 are living with chronic low back pain1.
Quite often, the cause of back pain remains unidentified. Moreover, the cause of chronic low back pain is often mixed. For example, it could be due to trauma, inflammation, neuropathic, and so on. In addition, it affects the lumbar spine and surrounding soft tissues2.
Since low back pain is caused by so many factors, identifying what causes low back pain is often challenging. Even imaging is of limited role in many cases. Therefore, no surprise that doctors even struggle to treat low back pain in many cases.
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Researchers at Stanford University think that cases with multiple associated painful conditions are generally more challenging to manage. Unfortunately, these patients do not respond well to conventional therapy.
Regretfully, very little is known about the other overlapping conditions that make low back pain worse. Thus, in one of the first studies of its kind, researchers tried to identify the overlapping painful conditions.
Researchers presented the finding of their study in an annual meeting of the American Academy of Pain Medicine3.
In the study, researchers included 8,783 patients’ data in their analysis. To their surprise, they found that an overwhelming 94.5% had associated painful conditions. Additionally, they discovered that overlapping painful conditions are more likely to exist in females. Moreover, in many, these associated painful conditions existed much before the chronic low back pain.
They classified these patients further into two groups. The first group had pain in one or two other areas (intermediate widespread), and the second group included those with widespread pains.
They found that widespread pains do not mean high pain scores in the patients. However, they discovered that associated painful conditions significantly affected the quality of life. Thus, having the worst clinical outcomes.
Some of the common complaints along with pain were fatigue, sleep issues, reduced physical function, pain interference, and anxiety. Researchers also found that these symptoms got worse with more widespread pain.
This research added to the understanding of chronic low back pain that pain score alone is not the best way to follow the progress of such patients. Instead, doctors need to pay attention to other issues affecting patients’ lives.
It also shows the importance of changing the treatment approach. For example, there is a need to manage depression, anxiety, sleep disorders, along with low back pain.
Researchers say that identifying patients with widespread pain is essential for providing personalized care. This study can also help provide a more holistic or comprehensive treatment plan. These findings do not contradict early findings that advocate a multidisciplinary and more comprehensive approach to painful conditions.
