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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 2, 189-195.
doi: 10.1302/0301-620X.84B2.12235  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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Somatisation predicts the outcome of treatment in patients with low back pain

R. Nickel, MD1; U. T. Egle, MD1; J. Rompe, MD2; P. Eysel, MD2; and S. O. Hoffmann, MD1

1 Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, Untere Zahlbacher Strasse 8, 55131 Mainz, Germany.
2 Clinic for Orthopaedics, Johannes Gutenberg University, Langenbeckstrasse 1, 55101 Mainz, Germany.

Correspondence should be sent to Dr R. Nickel.

We have assessed the influence of somatisation on the outcome of treatment in 81 patients with chronic low back pain.

All, irrespective of whether treatment was surgical or conservative, had a significantly better (p < 0.001) health-related quality of life at follow-up on all but one scale of the SF-36. Lower health-related quality of life at follow-up correlated significantly with a higher tendency to somatise before treatment and at follow-up. A logistic regression analysis yielded two factors which predicted the outcome; somatisation (p < 0.001) and ‘doctor shopping’ (the number of physicians consulted before the present inpatient treatment, p < 0.001). These factors accurately distinguished between patients with good and those with poor outcomes in 82%. Patients with somatisation and ‘doctor shopping’ were at a higher risk for a poor outcome. The results show the relevance of somatisation in the outcome of treatment in patients with low back pain.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General