A new study published in The Spine Journal examines patients who report the maximum pain scores on the visual analog scale.
There were 160 individuals examined for the study who reported a 10 out of 10 pain score on the VAS scale during initial presentation. The patients were diagnosed with lumbar degenerative disc disease with and without spinal stenosis. The study authors found:
1. Patients who reported the maximum VAS pain scores improved three points between their first visit and last follow-up after treatment.
2. After treatment, patients who reported initial maximum VAS scores were more likely to improve by 40 percent or more than patients who reported initial VAS scores under 10.
3. Identifiable secondary gains were more common among the patients who reported maximum VAS scores than those who reported submaximal pain.
4. Factors associated with dramatic pain score improvement — at least four points or more — include:
• Older age
• Not have secondary gains from their disease
• Non-smokers
5. Patients who continued to report maximum pain scores throughout treatment were more likely to be smokers.
"Our analysis supports the need to consider the influence of secondary gain on patients' reported VAS scores," concluded the study authors. "Maximum pain seems to be a more acute phenomenon with some likelihood to significantly improve."