Measuring severity of pain/disability is useful to monitor
effectiveness for treatment. Main components of mesuring back-related
disability are: pain evaluation, ambulation, sitting/standing, sleep
disturbance, and back pain function.
To plot out the causes and find oout
what triggers the pain needs detailed data. Asking the
patient to fill in their pain ratings at a
regular time such as wake up, breakfast, lunch, evening meal and
bedtime improves compliance. All medications taken and the time
are taken should also be noted. For intermittent chronic pain
syndromes, the onset and offset time of the pain, and its
maximum pain score should be recorded. It is also useful to ask some of
the pain sufferer to note activities and food and drink consumed in the
24 hours prior to the headache. Pain diaries can serve an important
identifying food allergies, diurnal rhythms, external stressors and
effectiveness of medication.
Getting the patient to do a timed 50 meters walk can act
as a guide for physical therapy success. As they cope more effectively
with pain the patients tend to decrease both their time and the number
of their pain behaviors.
This is another useful method of following physical improvement, in low back pain
patients. The number of times the patient can stand from a sitting
position, preferably from a chair without arms, in two minutes is
recorded. As physical function improves the number of repetitions the
patient is able to perform increases and the number of pain behaviors
The National Sleep Foundation reports that
2/3 of chronic pain sufferers experience sleep problems. Difficulty in
falling asleep, and number of awakenings because of pain
and duration of sleep during a 24 hour period are all self report
measures which should be asked. Improvements in sleep often correspond
with improvements in pain and dysfunction. Early morning awakening may
indicate significant depression.
Back Pain Function
The disability caused by back pain and
progress with therapy can be assessed objectively by a number of
measures.The dimensions measured in these instruments
pain, functional and pain-limiting activities. Below, a list of
back-related scales used commonly.