Relief from Back Pain Doesn't Always Improve Quality of Life
There's a weak but important link between pain, disability, and quality of life (QOL) in patients with low back pain. These are the findings of a study conducted in Spain at seven primary care centers of the Spanish National Health System. There were 195 patients in the study.

Even when treatment improved the patients' pain, they didn't necessarily get better. Disability and QOL remained unchanged after measurable changes in pain. Why is that? Studies show pain is influenced by physical factors such as how the muscles, joints, and ligaments work. Disability is linked more closely to psychological and social factors.

This study confirms these same findings from other reports. The authors suggest using separate measures for pain and disability. They point out that QOL depends more on how long the pain lasts than how intense it is. It's likely that other factors besides pain also affect QOL, but more study is needed to identify them.

In this study, the researchers found QOL worsened the longer the pain lasted. In fact the measure of QOL doubled from day one to day 14. In this study, the QOL test measured several areas of health: mobility, self-care, main activity, family or leisure activities, pain, and mood.

The authors conclude that treatment must focus on improving pain, disability, and QOL. It's likely that separate treatment programs are needed for each factor. Improving just one factor doesn't always change the others.
Francisco M. Kovacs, MD, PhD, et al. Correlation between Pain, Disability, and Quality of Life in Patients with Common Low Back Pain. In Spine. January 15, 2004. Vol. 29. No. 2. Pp. 206-210.