Recovery from low back pain. 1-5 year follow-up of 287 injury-related cases

Abstract

This study investigated the factors affecting recovery from low back injury. The study population was designed to be representative of patients presenting with back pain following soft tissue injury. A minimum follow up rate of 90 percent was achieved with a length of elapsed time from the injury of up to five years. Three established methods of assessment of disability and functional capacity (The Oswestry disability scale, The Waddell disability scale and The Waddell physical impairment rating) were compared to each other and a new scale (The Low-Back Outcome Scale) for the measurement of a patient's performance in employment, social activities and activities of daily living. The relationships of these scales to employment, psychological disturbance and other factors were defined. The Outcome Score designed for use in this study provided a comprehensive and discriminating assessment of patient function. Compensation (particularly lump sum claims), psychological disturbance at review, time off work, and age at injury were important factors in recovery; the diagnosis, type and severity of injury, migrant status and neurological deficits were not. Eight psychometric instruments were examined, and the combination of The Zung Depression Scale and The Modified Somatic Perception Questionnaire was found to be the most accurate in determining the presence of psychological disturbance in patients with low back pain.