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The contribution of pain drawings in the prediction of return to work in patients with acute or sub-acute low back pain
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Karolinska Institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle, Department of Neurobiology, Care Science and Society.
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(English)Manuscript (preprint) (Other academic)
National Category
General Practice
Identifiers
URN: urn:nbn:se:uu:diva-156552OAI: oai:DiVA.org:uu-156552DiVA: diva2:433099
Available from: 2011-08-08 Created: 2011-08-02 Last updated: 2018-01-12
In thesis
1. Low Back Pain: With Special Reference to Manual Therapy, Outcome and its Prognosis
Open this publication in new window or tab >>Low Back Pain: With Special Reference to Manual Therapy, Outcome and its Prognosis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives. To assess outcome of manual therapy in addition to stay-active care in sub-acute low back pain patients and to investigate the predictive power of pain drawing sketch variables for return to work.

Materials and methods. The study was designed as a randomised controlled trial with a factorial design, and included 160 patients with acute or sub-acute low back pain allocated to one of the four treatment groups during 10 weeks. Group 1 received stay-active care only, Group 2 the same treatment as in Group 1 + muscle stretching, Group 3 the same treatment as in Group 2 plus manual therapy, and Group 4 the same treatment as Group 3 plus steroid injections. Outcome included pain intensity, pain extension, functional and health related quality of life variables and return to work.

Results. Pain intensity and disability rating improved faster in Groups 3 and 4 than in Groups 1 and 2 (p<0.05 and p<0.05). Also health related quality of life was affected by the treatments given; the more treatment options the better the effect (trend across the groups p<0.05). Pain extension as described on a pain drawing sketch decreased in all groups across the study period. The pain modality ‘numbness’ was the most painful one among patients with no pain radiation. Pain radiation according to the pain drawing sketch was the strongest predictor for return to work (p=0.03, Wald χ2=4.56).

Conclusions. The manual therapy concept used in this study reduced pain intensity and disability rating better than the stay active concept. The effects on health related quality of life were greater the larger the number of treatment modalities available. Pain drawing information was significantly correlated with pain and functional variables. Pain radiation according to the pain drawing adds significant information to the prediction of return to work.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 79 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 691
Keyword
Low Back Pain, Manual therapy, Stay active care, Mobilisation, Manipulation, Pain drawing, Return to work, Prognosis, Disability rating, Pain
National Category
General Practice
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-156739 (URN)978-91-554-8122-3 (ISBN)
Public defence
2011-09-30, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskölds väg 20, Uppsala Science Park, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2011-09-09 Created: 2011-08-08 Last updated: 2018-01-12Bibliographically approved

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Grunnesjö, Marie IBogefeldt, Johan PBlomberg, Stefan I ESvärdsudd, Kurt F

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CiteExportLink to record
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