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Numeric pain scale7/6/2023 The interpretation whether or not a statistically significant change corresponds to a significant clinical change as well or defining a threshold remains challenging and needs further research. With regard to the current literature, it seems to be justifiable to use short time-periods of pain and disability recall for comparison of pain status of patients in the course of back disease. In the setting of pre-/postoperative follow-up investigations, it is unavoidable to use some kind of pain recall when ‘current pain’ as a test-parameter (as recommended above), is not used. As mentioned in the beginning, assessment of pain is broadly used in spinal surgery. stated that recall of chronic pain in terms of its average intensity, interference with activities (disability due to pain), number of days with pain and number of days with activity limitation, lead to acceptable validity levels. found that pain and disability recall become more and more influenced by the present pain and disability during a period of 1 year while the influence of actual relief and pain and disability reporting at the initial consultation decreased. It has been found that pain is usually overestimated when actual intensity of pain is higher and underestimated when it is lower. Whereas some studies find it to be unreliable to assess pain retrospectively others report acceptable levels of validity up to a 3-months recall period. Whether or not this is reliable is discussed controversially. Posing such questions relies on the assumption that patients are able to accurately recall their pain levels of a past period of time. 1 week, than to ask for ‘current’ pain at the specific time of fulfilling a questionnaire. As perception of pain may differ within a time-period, recent studies have mentioned that it is more valuable to ask patients to rate their ‘usual’ pain on average over a past short period of time, e.g. A lot of factors such as social situation, work situation and setting and history of prior injury may influence pain perception and show large inter-individual differences. Contrary to these findings, alternative methods of pain affect-assessing did not intercorrelate as high as those of pain intensity, making the utilisation of this part of pain characterisation more complicated. It has been shown that pain intensity may quite easily be declared by most patients and that different methods of measuring pain intensity showed high intercorrelation. Pain intensity describes how much a patient is in pain whereas pain affect describes the ‘degree of emotional arousal or changes in action readiness caused by the sensory experience of pain’. This contains pain intensity and pain affect. Using a depression scale of pain intensity during the past 6 months, the number of days with back pain and the number of days with pain from other pain sites as prognostic factors they were able to predict which patients would surpass the aforementioned thresholds of 50 and 80%. A 50–79% probability of future clinically significant pain was defined as ‘possible chronic back pain’ and an 80% or larger probability as ‘probable chronic back pain’. Von Korff and Miglioretti recently presented a prognostic approach to define chronic pain by defining it as a ‘clinically significant pain likely to be present for one or more years in the future’. Between 4 weeks and more than 1 year of persisting pain, he showed that there is no consensus on the above definition of chronicity. investigated 40 epidemiologic/therapeutic studies between 19 with regard to the definitions of chronic back pain that were used. In 1996, Von Korff and Saunders defined it as the back pain that lasts at least for half of the days during an year. In 1984, Nachemson and Bigos defined it as a period of at least 3 months with persisting pain. Different definitions of chronic back pain are in use.
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