Psychological and Behavioral Differences Between Low Back Pain Populations: A Comparative Analysis of Chiropractic, Primary and Secondary Care Patients
SOURCE: BMC Musculoskelet Disord. 2015 (Oct 19); 16: 306
Andreas Eklund, Gunnar Bergström,
Lennart Bodin and Iben Axén
Institute of Environmental Medicine,
Unit of Intervention and Implementation Research,
Nobels väg 13, S-171 77,
BACKGROUND: Psychological, behavioral and social factors have long been considered important in the development of persistent pain. Little is known about how chiropractic low back pain (LBP) patients compare to other LBP patients in terms of psychological/behavioral characteristics.
METHODS: In this cross-sectional study, the aim was to investigate patients with LBP as regards to psychosocial/behavioral characteristics by describing a chiropractic primary care population and comparing this sample to three other populations using the MPI-S instrument. Thus, four different samples were compared.
A: Four hundred eighty subjects from chiropractic primary care clinics.
B: One hundred twenty-eight subjects from a gainfully employed population (sick listed with high risk of developing chronicity).
C: Two hundred seventy-three subjects from a secondary care rehabilitation clinic.
D: Two hundred thirty-five subjects from secondary care clinics.
The Swedish version of the Multidimensional Pain Inventory (MPI-S) was used to collect data. Subjects were classified using a cluster analytic strategy into three pre-defined subgroups (named adaptive copers, dysfunctional and interpersonally distressed).
RESULTS: The data show statistically significant overall differences across samples for the subgroups based on psychological and behavioral characteristics. The cluster classifications placed (in terms of the proportions of the adaptive copers and dysfunctional subgroups) sample A between B and the two secondary care samples C and D.
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