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Making Back Pain Measure Up

The Swedish Lumbar Spine Study Group is busy measuring back pain. They are measuring pain before and after treatment to find out what treatments work best. They are also checking the test tools to make sure they can be trusted. How accurate are these tools used to measure low back pain?

This group compared four different tests used to measure the results of back treatment. They didn't find any difference comparing patients who had surgery and those who didn't. Patients in both groups had the same amount of change (better or worse) no matter what treatment was given.

Members from the study group say that a higher score after treatment doesn't always mean that the patient is better. How much change is needed before the patient says he or she is "better," "much better," or even "worse"?

After finding out a change has occurred, researchers want to know what caused the change. For example, did the score change because the patient could sleep better? A change in score could also happen when the patient lifts more weight or walks farther.

Three of the tests don't detect changes that are important to patients. Only one test, called the Visual Analogue Scale (VAS), measured small changes that are important to the patient. The VAS is a scale with numbers ranging from zero to 10 or zero to 100. Zero means "no pain" and 10 or 100 stands for "worst pain."

The VAS is a measure that detects even small changes in back pain and function after treatment. It can reflect changes in sleep, activities of daily living, and even mood. Improving the patient's ability to sit, stand, or lift is more difficult to measure.


O. Hägg, et al. The Clinical Importance of Changes in Outcome Scores After Treatment For Chronic Low Back Pain. In European Spine Journal. January/February 2003. Vol. 12. No. 1. Pp. 12-20.

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