Correlation of Pain Intensity and Disability in Low Back Pain

Patients in Pirngadi General Hospital

Stella Karvelin

Department of Physical Medicine and Rehabilitation,

Pirngadi General Hospital, Medan, Indonesia

Keywords: Low Back Pain, Pain Intensity, Disability.

Abstract: Low back pain ( LBP ) is one of the most common health problems among all the populations in the world

(2). Objective : The Goal is to determine the correlation between pain intensity and disability in patients

with low back pain. Materials and Methods : This study was a descriptive, analytical research with a cross

sectional design. Thirty Low Back Pain outpatients that have visited Physical Medicine and Rehabilitation

Clinic in Pirngadi General Hospital. Patient from June to July 2019 were selected by concecutive sampling.

a questionnaire was used that contained the items to collect sociodemographic, questions regarding the

perceived pain, and the Oswestry Disability Index (ODI). Result : Using pearson correlation test was found

a moderate correlation among pain intensity and disability (p=0,004, r = 0,507). Conclusion : Pain intensity

in outpatients with low back pain in the Physical Medicine and Rehabilitation Clinic at Pirngadi General

Hospital correlates with Disability.

1 INTRODUCTION

Low back pain (LBP) is defined as pain and

discomfort below the the costal margin and above

the inferior gluteal folds, with or without referred leg

pain (Duthey, 2013), and one of the most common

health problems among all the populations in the

world (Ramdas, 2018). In 2013, WHO(World health

organization) estimates the prevalence of LBP

reaches to 60-70% in indutrialized countries

(Ehrlich, 2003). More than 70% of persons in

developed countries will experience LBP at least

ones in their lives (Chour, 2011). In Indonesia

(2013) a lifetime prevalence of LBP between 59,3-

62,4% and annual prevalence within 20,9-31,2%.

LBP not only suffered by physical discomfort, but

also functional limitation that might cause disability

and interfere with their quality of life (Bukit, 2011).

According to The Global Burden of Disease

2010 study (GBD 2010), out of the 291 conditions

studied, LBP was ranked as the greatest contributor

to global disability measured in years lived with

disability (YLD), and the sixth in terms of overall

burden measured in disability-adjusted life year

(DALY). DALY is the standard metric used to

quantify burden (Hoy et al, 2014).

Sagmanli et al (2009) in his study of 118 patient

in Turkish found a strong relationship between level

of pain intensity and disability in patient with

chronic low back pain (CLBP) (Sagmanli et al,

2009). Similarly, a study by Guclu et al in 2012

found a correlation a pain intensity with the quality

of life that is the physical limitations due to physical

problems. The results of his study indicate that the

increased intensity of pain, the less physical function

of the patients (Guclu et al, 2012). A study in Brazil

found weak correlation between pain intensity and

disability in chronic back pain patients (Stefane et al,

2013).

Therefore, the researches are interested in

examining the relationship between pain intensity

and disability in low back pain patients in Pirngadi

general hospital.

2 METHODS

2.1 Participants

The research participants were from outpatient

clinics of the Department of Physical Medicine and

Rehabilitation in Pirngadi General Hospital. The

Karvelin, S.

Correlation of Pain Intensity and Disability in Low Back Pain Patients in Pirngadi General Hospital.

DOI: 10.5220/0009089903010303

In Proceedings of the 11th National Congress and the 18th Annual Scientiﬁc Meeting of Indonesian Physical Medicine and Rehabilitation Association (KONAS XI and PIT XVIII PERDOSRI

2019), pages 301-303

ISBN: 978-989-758-409-1

301

data were collected between June and July 2019

(n=30). The following inclusion criteria were LBP

outpatient at Pirngadi General Hospital PMR clinic .

The exclusion criteria were spinal tumor, infection

and pregnancy.

2.2 Methods

To achieve the objectives, a questionnaire was used

that contained the items to collect

sociodemographic, questions regarding the

perceived pain, and the Oswestry Disability Index

(ODI) .

The patients were asked about their last day pain

intensity score using the Numerical Categorical

Scale (0 to 10 points), with 0 indicating "no pain",

10 "maximum pain", while the other scores, from 2

to 9, indicate intermediary perceived pain levels .

The Oswestry Disability Index (ODI) mainly

assesses activity limitations and contains 10

different items-pain intensity, personal hygiene,

lifting, walking, sitting, standing, sleeping, sexual

activity, social activity and traveling which all were

scored on a six-point scale, with 0 representing no

limitation and 5 representing maximal limitation. A

percentage score from 0 to 100 is calculated (higher

score shows higher disability). The 0 to 20% -

minimal disability 20 to 40% - moderate disability,

40 to 60% - severe disability, 60 to 80% - crippled,

80 to 100% - bed bound (or exaggerating

symptoms).

3 RESULTS

3.1 The Demographic Profile of the

Studied Population

The age range of participants generally was 24-87

years with the mean age of 61,96 and standart

deviation(SD) 13,64. In LBP group, 70% were

female (n=21), and 30% were male (n=9), In the

term of marital status 96,7% were married and 3,3 %

were single, and the range of the body mass

index(BMI) was 16-33 kg/m

with the mean 25,13

and standard deviation 4,34 which the higher

percentage of BMI was overweight (43,3%) (Table

Table 1: Demographic Group.

Variables n %

Gender

Male

Female

Ages

<50

≥ 50

16,7

83,3

Married

Yes

96,7

3,3

Body Mass Index

Underweight

Normoweight

Overweight

Obesity

43,3

16,7

3.2 Pain Intensity and Disability Scale

The value of pain intensity (mean=6,53, SD=2,19)

and value of ODI ( mean = 40,5, SD = 12,12) (Table

Table 2: Pain intensity and disability.

Variables Mean SD

Pain Intensity 6,53 2,19

Disablities 40,5 12,12

3.3 Correlation between Pain Intensity

and Disability

Data were calculated using IBM SPSS Statistic for

Windows, Version 17.0. On overall subjects, the

normality value was measured using Kolmogrov

Smirnov test, Which we found that the distribution

was normal (p>0,05).

The correlation were calculated using Pearson

Correlation and has found moderate correlation

between pain intensity and disability ( p = 0,004 , r =

0,507)

4 DISCUSSIONS

Low back pain is the leading cause of activity

limitation and work absencethroughout much of the

world, and it causes an enormous economic burden

on individuals, families, communities, industry and

governments (Duthey, 2013)

LBP is associated with multiple risk factors,

including individual (e.g., gender, age, lifestyle,

physical capacity, and body weight), psychosocial

(e.g., anxiety, depression, social support, and job

KONAS XI and PIT XVIII PERDOSRI 2019 - The 11th National Congress and The 18th Annual Scientiﬁc Meeting of Indonesian Physical

Medicine and Rehabilitation Association

302

satisfaction), and physical factors(e.g., hard manual

work, heavy weight lifting, bending down or

twisting, etc.) (Sribatay et al, 2018), In this study,

the result showed that LBP more prevalent among

the female rather than the male, ≥50 years age

group, married participant and overweight

individuals seemed affected mostly. Present study

was corroborated by a study by Hoy et al, who

observed females to be more afected by back pain

than males(Hoy et al, 2018), The study of Septiana

M et al in 2013 of 51 LBP patients, 74,5 % were

aged ≥ 50 years and 51% were overweight

(Setyaningrum, 2014).

In this study showed there’s a moderate

correlation between pain intensity and disability, A

study conducted by Kim G et al that there’s a

significant correlation between pain intensity and

disability using Oswetry (Kim et al, 2015).

Similarly, the study of Stefane T et al have found

weak to moderate positive correlation between pain

and disability (Stefane et al, 2013)

The current study has several limitations, for

instance the small sample size and the patient’s pain

perception that is very subjective, so sometimes the

result obtained are not appropriate especially

patients were given questionaires before

physiotherapy.

5 CONCLUSIONS

This study shows that pain intensity in outpatients

with low back pain in the Physical Medicine and

Rehabilitation Clinic at Pirngadi General Hospital

correlates with disability.

ACKNOWLEGDEMENTS

The author thanks to dr Natalia Tianusa, Sp KFR,

My Family, Institutions, and friends that have helped

me to finished this research

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