Multimodal treatment for chronic lower back pain. Predictors of success

Objectives. In recent years, multimodal treatment programs for chronic lower back pain (LBP) have been successfully established, however, the availability of such programs is limited. The aim of this study was to determine the predictors of success in a multimodal pain treatment program. Methods. The study included 408 patients with chronic lower back or neck pain, who were admitted to a multimodal treatment program over 3 weeks. The German pain questionnaire was used for initial evaluation. Pain intensity was measured via VAS at the beginning of treatment and 6 months after therapy. The items on the pain questionnaire were tested by studying variance and regression analyses for their ability to predict treatment outcome (change of pain intensity). Results. The following items could predict treatment outcome: duration of current pain episode, application for pension, pain intensity and job satisfaction. Age, sex, pain location (neck pain versus LBP) and chronicity stage according to MPSS were not found to be significant predictors. Conclusions. According to our data, patients suffering from LBP or neck pain for less than 3 years, regardless of the stage of chronicity, can be expected to have a good outcome (pain reduction) after admission to a multimodal treatment program. Job satisfaction is a further predictor of good outcome. Predictors for a bad treatment outcome are: pain intensity less than 30/100 (VAS), pain duration longer than 3 years, and application for pension.