Article

Little is known about chronic low back pain (CLBP) in combination
with widespread musculoskeletal pain (WMP). OBJECTIVE: This study examined
factors that may be common to these conditions, with the objective of detecting
factors that could improve the course of these diseases. DESIGN: This was a
prospective case control study. PATIENTS AND INTERVENTION: A group of patients
with CLBP and WMP (CLBP+WMP group, n=97) was compared with a group of individuals
who were pain-free and without a history of musculoskeletal problems (control
group, n=97) and with a group of patients with CLBP but without WMP (CLBP-only
group, n=52). The mean age of the participants was 42.9 years (SD=8.74); 76% were
women, and 24% were men. MEASUREMENTS: A total of 74 variables were measured,
including sociodemographic, physical, and psychosocial variables. After
univariate examination for group differences and analyses of variables available
for all 3 groups, logistic regression on selected factors was performed. The
alpha level was set at .05, but was adjusted to avoid randomly significant
results. RESULTS: For a number of variables, significant differences among the 3
groups were observed. For regression model 1 for the CLBP+WMP and control groups,
4 out of 9 variables showed significant likelihood tests: income (lower in the
WMP group), depression, anxiety, and fear-avoidance behavior. For regression
model 2, 2 out of 13 variables showed significant likelihood tests: endurance
capacity (more in the CLBP+WMP group) and balance capability (worse in the
CLBP+WMP group). The models predicted at least 91.2% of all cases to the correct
group. The regression analysis regarding the CLBP+WMP and CLBP-only groups
predicted 86.7% of all cases to the correct group. Three out of 10 variables
showed significant likelihood tests: high disability, fear-avoidance behavior,
and number of treatments. Limitations: Some variables in testing the patients
with WMP and the individuals who were pain-free were not used with the patients
with CLBP only. CONCLUSIONS: Patients with CLBP and WMP should be examined for
indicated physical and psychosocial factors. Therapeutic management should
consider them in the early stage of the disease. These findings also might apply
to patients with fibromyalgia or myofascial pain.

Langue : ANGLAIS