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Efficiency and predictive parameters of outcome of a multimodal pain management concept with spinal injections in patients with low back pain: a retrospective study of 445 patients

  • Orthopaedic Surgery
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Abstract

Low back pain is one of the most common diseases of modern civilization. Multimodal pain management (MPM) represents a central approach to avoiding surgery. Short-term results are published rarely and often incomparable because of different treatment concepts. This study compared the subjective and objective parameters as well as the anamnestic and clinical parameters of 445 patients with low back pain before and after inpatient MPM to investigate the influence of this type of therapy on short-term outcome. The majority of patients were very satisfied (39%) or satisfied (58%) with the treatment outcome. The median pain reduction for back pain was 3.0 (IQR 2.88) (numeric rating scale, NRS), thus 66% and 2.75 (IQR 3.38, 62%) for leg pain. The main pain reduction occurred within the first 10 days of treatment and was clinically significant from day 5 onwards. The outcome for patients with hospitalization of more than 10 days was significantly worse. The parameters female sex, BMI of > 30, local pain, and pain duration of 3–24 months had a significantly better outcome. In contrast, age, treatment cause, depression, anxiety, and other diseases had no statistically significant influence on outcome. MPM therapy for more than 5 days seems to be an efficient short-term approach to treating low back pain. Knowledge of some of the outcome predictors helps to early identify patients who require more intensive individual care. In the case of no clear indication for surgery, MPM can be an appropriate treatment option.

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Acknowledgements

We are grateful to Monika C. Schoell for medical editing.

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Authors and Affiliations

  1. Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany

    Melanie Brunner, Timo Schwarz, Matthias König, Joachim Grifka & Achim Benditz

  2. Centre for Clinical Studies, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany

    Florian Zeman

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  1. Melanie Brunner
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  2. Timo Schwarz
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  3. Florian Zeman
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  4. Matthias König
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  6. Achim Benditz
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Contributions

MB, TS, MK, JG and AB made substantial contributions to the conception and design of the study. MB, FZ, MK and AB participated in the acquisition of data, analysis and statistics. All authors made contributions to the interpretation of data and have been involved in drafting the manuscript. All authors read and approved the final manuscript.

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Correspondence to Achim Benditz.

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The authors declare that they have no competing financial interests.

Ethical approval

The study was approved by the Ethics Commission of the University of Regensburg and carried out in accordance with the approved guidelines. Registration in Deutsche Register Klinischer Studien (DRKS), German Clinical Trials Register DRKS00011788.

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Brunner, M., Schwarz, T., Zeman, F. et al. Efficiency and predictive parameters of outcome of a multimodal pain management concept with spinal injections in patients with low back pain: a retrospective study of 445 patients. Arch Orthop Trauma Surg 138, 901–909 (2018). https://doi.org/10.1007/s00402-018-2916-y

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