Study identifies patient subgroups to guide non-surgical care for back and leg pain

A recent study by Associate Professor Sean D Rundell, PT, DPT, PhD, reports on the enrollment and baseline characteristics of participants in his NIH funded cohort study. The report finds different groups of patients who are seeking non-surgical treatment for their lumbar spinal stenosis.

For the study, the team recruited adults aged 50 and older who were beginning non-operative care for symptomatic lumbar spinal stenosis. Participants with other conditions, that limited walking, or those with a history of lumbar surgery, were excluded. 

This study identified four unique subgroups with distinct clinical profiles, which may enable further understanding of their health needs and allow for more patient-centered care. One group (39%) had high pain and disability but low psychosocial concerns, the second group (36%) had more modest pain and disability with low psychosocial concerns. The third group (16%) had high pain and disability with multiple other health and psychological factors, and the last group (9%) had new onset leg pain with high disability but few other health concerns.

A total of 598 participants were enrolled, with a mean age of 67 years and 61% identifying as female. Back and leg pain had persisted for at least one year in 65% of participants. Pain was often widespread, and more than half (54%) had multiple comorbidities. 

Understanding pertinent subgroups may help clinicians choose the best treatment and plan care. Future studies would provide long-term results to see how useful these types are in predicting outcomes and guiding care.

The study team included Professor Janna L Friedly, MD, MPH, and Professor Pradeep Suri, MD, MS, from the University of Washington Department of Rehabilitation. The team also included Eric N Meier, MS (Department of Biostatistics); Jeffrey G Jarvik, MD, MPH (Departments of Radiology and Neurological Surgery; Patrick J Heagerty, PhD (Department of Biostatistics); and Sandra K Johnston, PhD, RN (Clinical Learning, Evidence, and Research Center).