title: The course of pain drawings during a 10-week treatment period in patients with acute and sub-acute low back pain.
abstract: BACKGROUND
  Pain drawings are widely used as an assessment of patients' subjective pain in low back pain patients being considered for surgery. Less work has been done on primary health care patients. Moreover, the possible correlation between pain drawing modalities and other pain assessment methods, such as pain score and functional variables needs to be described. Thus, the objectives were to describe the course of pain drawings during treatment in primary health care for low back pain patients.
  
  
  METHODS
  160 primary health care outpatients with acute or sub-acute low back pain were studied during 10 weeks of a stay active concept versus manual therapy in addition to the stay active concept. The patients filled out 3 pain drawings each, at baseline and after 5 and 10 weeks of treatment. In addition the patients also reported pain and functional variables during the 3 measurement periods.
  
  
  RESULTS
  The proportion of areas marked, the mean number of areas marked (pain drawing score), mean number of modalities used (area score), and the proportion of patients with pain radiation all decreased during the 10-week treatment period. Most of the improvement occurred during the first half of the period. The seven different pain modalities in the pain drawing were correlated to pain and functional variables. In case of no radiation some modalities were associated with more pain and disability than others, a finding that grew stronger over time. For patients with pain radiation, the modality differences were smaller and inconsistent.
  
  
  CONCLUSIONS
  Pain modalities are significantly correlated with pain and functional variables. There is a shift from painful modalities to less painful ones over time.
authors.affiliation: Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Section, SE-751 85 Uppsala, Sweden. marie.grunnesjo@pubcare.uu.se
authors.forename: Marie
authors.initials: M
authors.lastname: Grunnesjö
authors.forename: Johan
authors.initials: J
authors.lastname: Bogefeldt
authors.forename: Stefan
authors.initials: S
authors.lastname: Blomberg
authors.forename: Heléne
authors.initials: H
authors.lastname: Delaney
authors.forename: Kurt
authors.initials: K
authors.lastname: Svärdsudd
mesh_terms: D000208:Acute Disease; D000328:Adult; D001154:Art; D004185:Disability Evaluation; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology* / Q000628:therapy*; D008875:Middle Aged; D009043:Motor Activity; D026201:Musculoskeletal Manipulations; D010147:Pain Measurement / Q000379:methods*; D011320:Primary Health Care / Q000379:methods*