Outcomes for those with or without physical comorbidity for a specific cohort of chronic low back pain patients in an active rehabilitation approach

Abstract

The objective of the study was to determine the relationship between physical comorbidity and outcomes in a cohort of chronic low back pain (LBP) patients (n = 2777). Patients were treated at one of 48 physiotherapy clinics between January 1, 2005 and September 30, 2006. All patients were categorized into either: (i) physical Comorbidity Group (n = 898), or (ii) only Back Pain Group (n = 1879). There were no baseline statistical differences in symptom duration, visual analogue scale, function and medication use between groups. The Comorbidity Group was significantly older by 5 years and more females (p < 0.0001); odds ratios were adjusted for age and sex. Logistic regression analysis revealed no statistically significant differences for change in functional score (OR = 0.996), change in pain rating (OR = 1.013) and total treatment sessions (OR = 0.997), between groups. Those with LBP and a physical comorbidity (coronary artery disease, hypertension, rheumatoid arthritis, diabetes, non-spinal malignancy, chronic obstructive pulmonary disease, or any other non-spinal condition) had no statistically significant differences in outcomes compared with those with LBP only. The clinical approach to chronic low back patients with an associated physical comorbidity may initially seem more intimidating or complex, but the potential for recovery is just as favourable as that for patients with uncomplicated chronic LBP.

Key words::

• Cohort
• physical comorbidity
• physiotherapy
• treatment
• recovery

Acknowledgements

The authors thank the clinics in the following locations for data collection: British Columbia (Burnaby, Coquitlam, Duncan, Fraser Valley, Langford, Nanaimo, Prince George, Richmond, Sumitt DT, Surrey, Vancouver, Victoria); Alberta (Burnewood, Calgary [Downtown, North, South], Deer Valley, Edmonton, Fort McMurray, Lethbridge, Red Deer); Saskatchewan (Erindale, North Battleford, Regina, Saskatoon); and Ontario (Barrie, Brampton, Cambridge, Hamilton, Hamilton Mountain, Kanata, Kitchener, Leamington, London [Central, East], Mississauga, Niagara Falls, Ottawa [East, West], Sarnia, Sudbury, Thunder Bay, Toronto [Danforth, Eglington, Etobicoke, Plaza Club, Scarborough, Woodbridge]).

No funding sources were utilized to complete this project.

This study was approved by the Research Ethics Board of Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.