Abstract
Background: Chronic low back pain (CLBP) is a complex health problem often resulting in difficult consultations for both patients and practitioners. Triggers for consultation may include pain severity, impact of pain on health-related quality of life and troublesomeness of pain. Troublesomeness of CLBP may be influenced by patients’ beliefs about their health, such as beliefs about what is acceptable for their age or lifestyle and their perceptions of risk. Therefore, troublesomeness may be a powerful trigger for consultation for CLBP.
Aim: To explore whether troublesomeness of CLBP is associated with consultation.
To determine the most powerful predictors of consultation for CLBP from pain severity, troublesomeness, health related quality of life and psychological distress
Method: Postal questionnaire survey to randomly sampled patients registered with 18 MRC General Practice Research Framework general practices (5400 patients) with two reminders. Questionnaire measures persistent pain (presence and location), pain severity (using the Chronic Pain Grade questionnaire), health related quality of life (EQ5D), psychological distress (GHQ12), troublesomeness of pain on a simple five point Likert scale and patient demographics.
Chi square tests will be undertaken to explore the relationship between troublesomeness of CLBP and consultations for pain in general and with whether consulted mainstream or complementary practitioners. Multiple logistic regression will be undertaken to explore the most powerful predictors of consultation for CLBP.
Results: The survey is ongoing. A full data-set will be available for the presentation. So far 354 questionnaires have been returned, 48% (167/347) of participants report persistent pain of these 62% (104/167) reported at least moderately troublesome CLBP. Of those reporting troublesome CLBP, 74% (76/103) had consulted their GP, 87% (90/103) had consulted other practitioners including physiotherapists, osteopaths and chiropractors, 27% (28/103) had seen a hospital consultant and 17% (18/103) had consulted no one.
Conclusions: These data suggest that troublesomeness is a simple way to improve the ability of epidemiological studies of back pain to contribute to health needs assessment.
Correspondence should be addressed to the editorial secretary: Dr Charles Pither, c/o British Orthopaedic Society, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
