The National Institutes of Health Pain Consortia task force has released recommended research standards for clinical low-back pain in hope that more consistency will generate better treatment solutions for the approximately 100 million adults in the Unites States with chronic pain.
Low-back pain is the second most common neurological disorder in the U.S. behind headache, and is the most common cause of job-related disability. But despite its widespread occurrence, research into prevention and treatment strategies has been stymied by inconsistent terminology and outcome measures. The task force, formed in 2012, set out to develop field-specific standards to address those issues.
In order to develop the standards, the task force focused on a set of principles that emerged following meetings and literature reviews, including:
- The process should be evidence-based and use a biopsychosocial model of chronic pain.
- Data should be useful for patients with degenerative disorders (e.g., herniated disc, lumbar stenosis) as well as those without clear pathoanatomy.
- Patients with underlying systemic or specific diseases were not the target of the Task Force.
- Patients with no clear pathoanatomy should not be assumed to have “psychogenic” pain.
- Classifying cLBP by impact is more feasible and potentially useful than classifying solely by pathophysiology. “Impact” includes pain intensity, interference, and physical function.
- A brief minimal uniform dataset should be reported in all studies of chronic back pain.
- The dataset should be relevant for population, observational, and interventional research.
- An investigator could substitute more detailed and precise measures for a particular domain but should report data for each domain of the minimal dataset.
- Research standards should evolve; we propose a potential research agenda for refinement.
The task force’s recommendations include a standard set of data collection questions or a uniform minimal dataset meant to increase consistency across studies. The questions address factors such as length of time a patient has had low-back pain, functional limitations, use of treatment approaches, and impact on factors like mood or sleep.