Patients with low back pain differ from those who also have leg pain or signs of nerve root involvement – a cross-sectional studyReport as inadecuate




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BMC Musculoskeletal Disorders

, 13:236

Rehabilitation, physical therapy and occupational health

Abstract

BackgroundLeg pain associated with low back pain LBP is recognized as a risk factor for a poor prognosis, and is included as a component in most LBP classification systems. The location of leg pain relative to the knee and the presence of a positive straight leg raise test have been suggested to have clinical implications. To understand differences between such leg pain subgroups, and whether differences include potentially modifiable characteristics, the purpose of this paper was to describe characteristics of patients classified into the Quebec Task Force QTF subgroups of: 1 LBP only, 2 LBP and pain above the knee, 3 LBP and pain below the knee, and 4 LBP and signs of nerve root involvement.

MethodsAnalysis of routine clinical data from an outpatient department. Based on patient reported data and clinical findings, patients were allocated to the QTF subgroups and described according to the domains of pain, activity limitation, work participation, psychology, general health and clinical examination findings.

ResultsA total of 2,673 patients aged 18–95 years median 47 who were referred for assessment of LBP were included. Increasing severity was consistently observed across the subgroups from LBP only to LBP with signs of nerve root involvement although subgroup differences were small. LBP patients with leg pain differed from those with LBP only on a wide variety of parameters, and patients with signs of nerve root involvement had a more severe profile on almost all measures compared with other patients with back-related leg pain.

ConclusionLBP patients with pain referral to the legs were more severely affected than those with local LBP, and patients with signs of nerve root involvement were the ones most severily affected. These findings underpin the concurrent validity of the Quebec Task Force Classification. However, the small size of many between-subgroup differences amid the large variability in this sample of cross-sectional data also underlines that the heterogeneity of patients with LBP is more complex than that which can be explained by leg pain patterns alone. The implications of the observed differences also require investigation in longitudinal studies.

KeywordsClassification Cohort studies Low back pain Radiculopathy Sciatica Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-13-236 contains supplementary material, which is available to authorized users.

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Author: Alice Kongsted - Peter Kent - Hanne Albert - Tue Secher Jensen - Claus Manniche

Source: https://link.springer.com/







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