Articles: back-pain.
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The Dallas Pain Questionnaire (DPQ) was developed to assess the amount of chronic spinal pain that affects four aspects (daily and work-leisure activities, anxiety-depression, and social interest) of the patients' lives. Results of the DPQ's statistical properties suggest that the DPQ is an externally reliable instrument as well as internally consistent. Two factors emerged from factor structure analysis. ⋯ A t test demonstrated that chronic pain patients have significantly higher DPQ scores than normals. Because these findings support its statistical properties, the DPQ appears to have utility for clinical and research purposes. The findings, limitations, and implications of this study are detailed, as are suggestions for future research.
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The use of strategies for coping with chronic pain was assessed by means of the Coping Strategy Questionnaire (CSQ) in a Dutch sample of 108 chronic low back pain (LBP) patients referred for behavioral treatment. The 3 factors of the CSQ were related to measurements of behavioral and emotional adjustment to LBP above and beyond the effects of demographic and medical status variables. Especially patients high on the factor Helplessness reported higher levels of pain, functional impairment, anxiety, depression and psychoneuroticism, while patients high on the factor Perceived Control reported lower levels of pain, functional impairment and also manifested a higher level of uptime. The causal role of coping strategies in adjustment to pain, the selectivity of focusing on LBP patients selected through referral and implications for pain management are discussed.
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Long-term outcomes for 300 chronic back pain patients were assessed retrospectively by a telephone follow-up 4-6 years after the patients were evaluated by a multi-disciplinary rehabilitative program. A Perception of Disability scale, developed to rate subjective disability, was used along with objective measures of functioning. On objective measures, 56% of patients reported themselves working or work ready, 58% no longer received compensation, 62% were taking no prescription medications and 65% had no or brief medical treatment since evaluations. ⋯ There was a strong relationship between perceived disability and objective circumstances with 63% of the patients unable to work and 61% still on disability payments reporting their disability as increasing. Of the 48 patients reporting back surgery at some point after evaluation only 17% perceived themselves as improved while 58% considered themselves worse. These results are discussed in the context of the development of pain focussed lifestyles.
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An outpatient treatment programme for pain control was applied in 25 chronic pain patients in three general medical practices, supervised by a medical psychologist as a group therapist. The patients has been suffering from headaches, migraines, cervical pain, shoulder and arm pain, and low back pain for at least 6 months. A sample of 20 patients with the same disorders served as a control group which waiting for treatment. ⋯ Nonetheless, all the subjects treated showed improvements in their average scores for trait anxiety, depression and symptoms complaints compared with the untreated controls. Our results indicate a long-term improvement in well-being as a result of the treatment. Treatment adherence seems to be the most important factor in the maintenance of long-term reduction of pain intensity.