A RETROSPECTIVE ANALYSIS OF THE EFFECTIVENESS OF INPATIENT REHABILITATION FOR CHRONIC BACK PAIN IN MILITARY PERSONNEL

Abstract

Objectives To assess the effectiveness of inpatient rehabilitation for military patients suffering with chronic back pain Design Retrospective analysis of a military medical database and hospital records Setting Defence Medical Rehabilitation Centre, UK Participants Patients who had attended and completed an inpatient rehabilitation course during the period June – Dec 2012. Main outcome measures Age, Sex, Service, Diagnosis, GAD7, PHQ9, FAA, STARTBACK9, VAS, ODI, HADS, EQ-5D, BPI, Health State and Simple Pain Score. Where possible, these measures were further expanded to their constituent domains: EQ-5D to EQ-5D VAS, EQ-5D M, EQ-5D S, EQ-5D U, EQ-5D P, EQ-5D A; HADS to HADS A and HADS B; BPI to BPI severity and BPI interference. Results 80 patients were enrolled from 12 courses held during the 6-month period between June-Dec 2012. The average age was 34.5 yrs. (21-53). Sex distribution was 87% Male to 13% female. Discogenic pathology was the primary pathology in 45%, facet-joint pathology in 22.8%, and muscular problems in 5%. 64% showed signs of at least mild generalized anxiety disorder. 38.2% had moderate-severe depression in the last 2 weeks, with 3.9% regarded as severe. 61% of patients stated they felt an improvement in their pain over the course, however 38.4% felt they worse. 57.9% showed an improvement in well-being, 13% reporting no change, and 28.9% feeling worse after the course. Conclusions Military populations experience much higher levels of chronic back pain than the general population, and at a younger age. Pain improves in these courses however activities of daily living do not improve and further assistance is required. There are high levels of undiagnosed and untreated anxiety and depression amongst 3 military personnel with chronic back pain, and these courses do not provide sufficient assessment or therapy for these conditions. Most patients have a poor outlook about returning to full military duties.