Low back pain management in routine clinical practice: what is important for the individual patient?

Abstract

Chronic low back pain is a complex disorder influenced by biological, psychological, and social factors. Causes, personal circumstances and personal disease experiences are varied; patient care thus needs to be tailored to the individual. Supported by clinical study results and online patient survey data, the present paper explores factors which are important to the patient beyond pain relief and proposes topics to be raised in consultation to identify the most important treatment goals. Furthermore, the importance of communication, trust and empathy in the physician-patient relationship for effective pain management is addressed. Plain language summary Effective treatment of chronic low back pain requires clear communication between patient and doctor/healthcare team. Although patients primarily expect and hope for pain relief under treatment, the reasons why they want to achieve a reduction of the pain might differ and might not even be obvious to them at the beginning of the consultation. For some patients, the pain itself might be unacceptable, for others, the issue might be restrictions in mobility or functioning in daily life because of the pain. Defining treatment goals can help identifying these underlying reasons. Using observations from his clinical pain specialist practice and supported by clinical study data and a survey of patients, the author aims to determine patients' most important treatment goals and makes suggestions on how these treatment goals can be identified in consultation with the individual patient.