Oral Presentation 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

Patient-reported outcomes in a community sample of individuals with chronic low back pain: Baseline behavioral-psychosocial features of the University of Pittsburgh’s Low Back Pain - Biological, Biomechanical, Behavioral Phenotypes (LB3P) project (115754)

Carol M Greco 1 2 , Paul A Pilkonis 2 , Nathan E Dodds 2 , Lan Yu 3 , Amanda M Acevedo 4 , Michael J Schneider 5 6 , Ajay D Wasan 7 , Jessa Darwin 8 , John Jakicic 9 , Sara R Piva 1 , Kevin Bell 10 , Nam Vo 11 , Charity G Patterson 1 , Gina P McKernan 8 , Gwendolyn A Sowa 8 11
  1. Physical Therapy, University of Pittsburgh, Pittsburgh, PA, United States
  2. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
  3. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
  4. Behavioral Research Program, National Cancer Institute, Rockville, MD, United States
  5. Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, United States
  6. Doctor of Chiropractic Program, , University of Pittsburgh, Pittsburgh, PA, United States
  7. Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
  8. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States
  9. Department of Internal Medicine, University of Kansas Medical Center, University of Kansas Medical Center, Kansas City, KS, United States
  10. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
  11. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, United States

Introduction. Chronic low back pain (cLBP) is complex, disabling, and costly to patients and society. Patients’ social circumstances, beliefs, and behaviors interact in a dynamic way with biomedical factors and have the potential to amplify suffering. To optimize understanding of pain and improve clinical treatment, it is important to assess patients’ experience of pain via patient-reported outcome (PRO) measures. This report describes baseline visit PROs collected in a prospective observational cohort study, Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes (LB3P).1

 

Methods. The 1,007 LB3P study participants completed numerous computerized PROs, including the minimum data set assessments of the NIH Research Task Force on back pain2 and the NIH HEAL Initiative’s Common Data Elements.3 PROs were organized into five conceptual domains: 1) Pain Characteristics and Qualities, 2) Pain-related Psychosocial Factors, 3) General Psychosocial Factors, 4) General Health and Lifestyle Factors, and 5) Social Determinants of Health. Patient Acceptance of Symptom Status, which consists of yes/no responses to ten questions about whether the level of each of ten symptoms is satisfactory, was also collected. Measures of central tendency were calculated (means and standard deviations for continuous data, and percentages for dichotomous or categorical data) for the overall sample, and stratified by sex at birth and age categories (younger than 60, and 60 and older).

 

Results. Approximately 60% of participants reported pain duration of more than 5 years, and 75% rated the frequency of pain as every day or nearly every day over the past six months. Pain intensity on a 0-10 scale was 5.5 (SD 2.1) and pain interference was moderate (PROMIS Pain Interference T-score 60.6, SD 7.3). Neuropathic pain, assessed via PainDETECT, was present in 18% of the overall sample, and in 22.5% of those younger than 60. On average, fatigue, depressive and anxiety symptoms, memory and concentration, self-efficacy and positive outlook were within normal limits, as indicated by PROMIS T-scores. However, PROMIS Physical function was below normal, with T-scores in the mild to moderate range of impairment. When participants were asked to rate the acceptability of their symptom status in 10 areas of function, the most frequently reported areas of dissatisfaction were: Pain intensity and interference, physical function, sleep, and social role functioning. In the area of social determinants of health, nearly half (44%) of participants reported having been exposed to traumatic experiences. In the overall group, 36% reported difficulty paying for basic needs such as food, medical care and heating, while 51% of those in the under 60 age group reported this level of financial strain. 

 

Discussion. The PRO data obtained from the LB3P observational study are a valuable source of information that will be combined with results from other biomechanical and biological variables for phenotyping of cLBP. The PRO results also provide a set of norms for persons with cLBP who are not necessarily seeking or engaged in pain treatment.