(643) Quality of Life (SF‐36 ″ ) for Patients with Lower Back Diagnoses Associated with Chronic Pain

Authors: Rollin Gallagher, MCP Hahnemann School of Medicine; Lamar Moree, Pain Medicine Center; Samir Mody, Janssen Pharmaceutica; Anita Hsu, Janssen Research Foundation; Sheri Dodd, Janssen Pharmaceutica; Jana Mossey, Drexel University School of Public Health Purpose: To describe the effect of chronic low back pain (LBP)diagnosis on several dimensions of health status measured with the SF‐36, using a patient database from a large pain clinic practice. Methods: 4,056 consecutive patients attending a pain clinic completed the SF‐36 and a clinical questionnaire on initial visit. Each patient in the sample was clinically diagnosed by a single pain medicine physician. A subset of patients with diagnoses consistent with low back problems were identified. The SF‐36″ was scored using standard algorithms, and reliability and validity of the scales were assessed (MAP‐R″). A comparison normal sample was generated from the normed data contained in the SF‐36 Health Survey Manual and Interpretation Guide to assess the significance of the impact of LBP diagnosis on SF‐36 scores relative to age and gender. Results: There were 4,056 patients for whom 13,019 diagnoses were recorded. 1,449 patients had at least one diagnosis consistent with LBP. These patients were predominately female (59.2%) with an average age of 56.4 (SD 15.9). The most common diagnoses were radiculopathy (62.2%), disc herniation (17.7%), and spinal stenosis (5.3%). Other diagnoses included arachnoiditis; disc herniation; disc protrusion; facet arthropathy; lumbago; lumbar stenosis; nonspecific low back pain without evidence of spinal disease; radiculopathy; sacroiliac dysfunction; spinal stenosis; spondylolysis; spondylolisthesis; failed back surgery; piriformis; postlaminectomy. Scores on all 8 domains of the SF‐36 were significantly lower ( P <.0001) than the simulated normal population, indicating the negative impact on overall health status of persons with chronic LBP when controlling for age and gender. The largest discrepancy between the LBP sample and normal sample was in the scale measuring physical functioning (role physical). Conclusion: These data from this large sample of consecutively treated patients attending a pain clinic documents the negative impact of low back problems on overall health status as measured by the SF‐36.