by Alan Jordan
In a recent article in the Broadgate Journal, we reviewed how pain is measured and quantified in a clinical setting.
This article will take a look at how clinicians are able to measure the ability of patients to manage daily activities and work – alongside their lower back pain.
These measuring instruments have been developed by the research community in order to compare the clinical effects of one treatment versus another. They are called Disability Scales and in the recent past, clinics have begun to employ these scales in order to carry out a validated audit of their practices.
The two most widely known scales are The Oswestry Disability Index, which was developed by a group of orthopaedic surgeons in Wales and The Roland Morris Disability Scale, developed in the UK. The Oswestry Disability Index is more commonly used to measure surgical outcomes while the Roland Morris Disability Scale is more commonly used in a clinical setting such as Broadgate.
Patients are asked to fill out questionnaires that ask a series of questions related to daily activities and the impact that their lower back pain is having on their ability to carry out these functions.
A few sample questions are given below:
- I stay at home most of the time because of the pain in my back.
- I change position frequently to try to make my back comfortable.
- I walk more slowly than usual because of the pain in my back.
- Because of the pain in my back, I am not doing any of the jobs that I usually do around the house.
- Because of the pain in my back, I use a handrail to get upstairs.
- Because of the pain in my back, I lie down to rest more often.
- Because of the pain in my back, I have to hold on to something to get out of a reclining chair.
- Because of the pain in my back, I ask other people to do things for me.
- I get dressed more slowly than usual because of the pain in my back.
- I only stand up for short periods of time because of the pain in my back.
There are 24 questions in all and a disability percentage is then determined.
This information assists clinicians in determining the severity of the back pain disability and how significantly it is impacting patients. This information is essential for clinicians to design an appropriate treatment plan for individual patients and furthermore, it can be administered during the course of treatment in order to determine if the treatment is having the desired effect.
At the Broadgate Spine & Joint Clinic, we strive to improve all aspects of our care, and clinical audit is an area where we are actively developing appropriate instruments that measure the effect that patients are undergoing.
This article was written by chiropractor and Broadgate Spine & Joint Clinic director Alan Jordan. If you would like more information about his work, you can find it here https://www.broadgatespinecentre.co.uk/chiropractor-london/.