Newswise — Approximately 50 million adults in the United States suffer from chronic pain, with 20 million having high-impact chronic pain that interferes with work or life most days or every day, according to the Centers for Disease Control and Prevention, with the lower back being the anatomical site most often affected by chronic pain. According to the US Bone and Joint Initiative, back pain costs the United States economy an estimated $253 billion each year in treatments and lost wages.

A recent article, published in the Journal of General Internal Medicine, provided some insight into why chronic low back pain may be difficult to treat.

Data published from the PRECISION Pain Research Registry, which looked at 289 chronic low back pain patients over a one-year period, demonstrated that pain intensity, physical function and five quality-of-life measures remained generally stable regardless of patient characteristics and the treatments they used.

John Licciardone, DO, MS, MBA, a regents professor in family medicine at the UNT Health Science Center who leads the research registry study team, said that when monitoring three key outcomes related to chronic low back pain, there were no significant changes over four different time points during a one-year period. The outcomes used were pain intensity, measured on a scale of 0-10; physical function, which asks patients to rate how chronic low back pain affects several aspects of daily living and their ability to work; and five quality-of-life indicators including sleep disturbance, pain interference with activities, anxiety, depression and low energy/fatigue.

“We know that people suffer from chronic low back pain for years,” explained Dr. Licciardone, “but what was surprising looking at these data, was just how stable the outcomes were for these 289 patients across a one-year period. The outcomes they reported didn’t change over four quarterly time points in that year regardless of their demographic characteristics and the various treatments they used, including prescription medications.”

Dr. Licciardone, who has been a leading pain researcher for the past 20 years, went on to note that these data are based on the patients’ real-world experience with chronic low pain as the research registry does not provide any diagnostic testing or treatment, but rather, uses information collected from patients as a way to monitor and assess the treatments currently being used by people with chronic low back pain in an effort to develop more effective ways to treat the condition in the future.

In this analysis, the average age of patients included was 54-years-old, 72 percent were women, 32 percent reported identifying with a race other than white, 13 percent were Hispanic, 47 percent reported a history of depression, 37 percent reported that they were unable to do their usual work for one month or longer because of their low back pain, 35 percent reported that they currently used opioids to treat their low back pain, and 15 percent reported previous low back pain surgery to treat their pain, Dr. Licciardone explained.

The PRECISION Pain Research Registry was created to study a wide range factors related to chronic low back pain including the treatments that patients use to manage their low back pain, as well as the impact chronic low back pain has on their daily lives. The effectiveness of these treatments is measured by how they improve people’s ability to complete day-to-day tasks, a wide range of quality-of-life and psychological indicators, and side effects potentially related to the treatments used. Since being established in April 2016, over 700 people have enrolled in the registry. More information about the PRECISION Pain Research Registry may be found at

The University of North Texas Health Science Center is home to six graduate colleges for health care providers, researchers and scientists. The campus has a strong culture based on values, and through extraordinary teamwork, produces leaders in health care and science who transform lives. The UNT Health Science Center will be celebrating its 50th anniversary in 2020.


Journal Link: Journal of General Internal Medicine 2020 Feb 19. doi: 10.1007/s11606-020-05723-3. [Epub ahead of print] No abstract available. PMID: 32076968