Low Back Pain: A Real Pain to DiagnoseLow back pain is a real pain for doctors, too. It's hard to find a specific cause, and it's almost impossible to predict who will develop chronic problems. There aren't even any foolproof tests to help doctors determine which back patients should get disability status. Much medical research has focused on developing better ways to accurately measure patients' disability.
These authors compared the results of two common tests that take place in the doctor's office. The idea was to figure out if the results from the two tests related well. The study involved 83 patients with low back pain. Doctors measured the patients' mobility using six common physical tests. The patients also filled out a widely used questionnaire. It asked questions about their activities and limitations because of low back pain.
Neither type of test is perfect. Questionnaires are obviously very subjective. But physical exams can also be affected by patients' states of mind. Patients may exaggerate their symptoms--maybe they don't want to go back to work, or maybe they're afraid of even worse injury. Patients might also play down their symptoms, feeling like they should just "tough it out."
The authors found a weak to moderate correlation between the physical exams and the questionnaires. This led them to conclude that both types of tests are important in determining patients' disability levels. Neither test is perfect, but together they give more complete information than alone.
C. Ellen Lee, MS, PT, et al. Self-Reports and Clinician-Measured Physical Function Among Patients With Low Back Pain: A Comparison. In Archives of Physical Medicine and Rehabilitation. February 2001. Vol. 82. No. 2. Pp. 227-231.
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