In a recent study Brown and colleagues aimed to define how patients determined success in the treatment of chronic spine pain in four domains: pain, fatigue, emotional distress, and interference with daily activities. They recruited 70 patients with chronic spine pain (43 women, 27 men; mean age, 50.9 years) from several pain clinics. Just before and two months after treatment, each patient completed outcome questionnaires measuring pain and other related factors ("usual" level and "success" level) on a 0-to-100 numerical pain-rating scale. At pretreatment, the patients anticipated that successful treatment would be a pain level of 26.9, a fatigue level of 23.2, an emotional distress level of 18.3, and an interference with daily activities level of 21.6. During treatment, however, the patients became less stringent in their idea of how much pain reduction represented success.

By posttreatment, the same patients said that their criteria for successful pain management would be a pain level of 33.9. Other posttreatment criteria for success also changed: a fatigue level of 30.2, an emotional distress level of 26.1, and an interference with daily activities level of 28.1. The authors write, "These findings suggest spine pain patients also require large reductions" in these other domains in order for treatment of pain to be successful.

Brown JL, et al. Pain Med 2008;9(7):851-62.