Management of chronic low back pain and the impact on patients' personal and professional lives: Results from an international patient survey

Abstract

Objective: The objective of this study was to investigate the impact of chronic low back pain (CLBP) on patients' personal and professional lives, and management strategies applied to treat CLBP.

Methods: A 60-question survey was developed, and respondents from 16 countries with a self-reported physician's diagnosis of CLBP were recruited via an online market research survey panel. Respondents were stratified as having mild, moderate, or severe pain. Target sample sizes per country and for pain severity were set. Data were weighted according to the known population and prevalence of CLBP in each country and the number of respondents from that country.

Results: Results from 9642 CLBP patients indicated that almost a quarter of patients with severe CLBP report a psychological comorbidity. Prescription pain medications were more commonly used by patients with severe CLBP (56%) than those with mild (20%) or moderate (34%) CLBP. Among those with severe CLBP who had been prescribed pain medication, 58% were prescribed opioids, with 1 in 4 patients using opioids for more than 5 years. Patients were primarily managed by general practitioners/primary care physicians, physiotherapists, neurologists, or orthopedic surgeons. CLBP negatively impacted patients' daily activities, social lives, and work productivity.

Conclusion: Chronic low back pain has pronounced effects on patients' personal relationships, ability to work, and daily living. Almost 1 in four patients with severe CLBP reported a psychological comorbidity. Adherence to guidelines appears inconsistent, which is noteworthy as a substantial subgroup of patients with severe CLBP had been prescribed opioid medication for more than 5 years. Improved education is required to support healthcare professionals (HCPs) in identifying and understanding the complex biopsychosocial needs of CLBP patients to optimize pain management and to encourage referral of CLBP patients to physiotherapists and psychologists.

Keywords: biopsychosocial model; chronic low back pain; international patient survey; pain management; psychological comorbidity.

FIGURE 1

Design and results from screening survey

FIGURE 2

Effect on social life as a result of CLBP, split by CLBP severity. Percentages and weighted counts are shown of patients who agreed with the statements. To count as agreement, patients had to respond “strongly agree” or “somewhat agree.” CLBP, chronic low back pain

FIGURE 3

Patients’ agreement with positive and negative statements about work, according to the Stanford Presenteeism Scale. To count as agreement, patients had to respond “strongly agree” or “somewhat agree.” To count as disagreement, patients had to select “somewhat disagree” or “strongly disagree”

FIGURE 4

Percentages and weighted counts of patients who agreed with statements about feelings toward their work. To count as agreement, patients had to respond “strongly agree” or “somewhat agree”