Perception of disability in chronic back pain patients: a long-term follow-up

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. Perceived disability, however, suggested a bleaker outcome picture with only 29% of patients perceiving themselves as improving. 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.