The relationship between religion/spirituality and physical health, mental health, and pain in a chronic pain population.

This study sought to better understand the relationship between religion/spirituality and physical health and mental health in 122 patients with chronic musculoskeletal pain. The current study conceptualized religion/spirituality as a multidimensional factor, and measured it with a new measure of religion/spirituality for research on health outcomes (Brief Multidimensional Measure of Religion/Spirituality). Pain patients' religious and spiritual beliefs appear different than the general population (e.g. pain patients feel less desire to reduce pain in the world and feel more abandoned by God). Hierarchical multiple regression analyses revealed significant associations between components of religion/spirituality and physical and mental health. Private religious practice (e.g. prayer, meditation, consumption of religious media) was inversely related to physical health outcomes, indicating that those who were experiencing worse physical health were more likely to engage in private religious activities, perhaps as a way to cope with their poor health. Forgiveness, negative religious coping, daily spiritual experiences, religious support, and self-rankings of religious/spiritual intensity significantly predicted mental health status. Religion/spirituality was unrelated to pain intensity and life interference due to pain. This study establishes relationships between religion/spirituality and health in a chronic pain population, and emphasizes that religion/spirituality may have both costs and benefits for the health of those with chronic pain.

Lumbar arthrodesis for degenerative conditions.

There is significant disagreement among spine surgeons regarding the optimal technique of arthrodesis for treatment of degenerative disorders of the lumbar spine. Degenerative conditions of the lumbar spine include degenerative disk "disease," post-decompression degeneration, degenerative spondylolisthesis, junctional degeneration, spondylolis, and low-grade lytic spondylolisthesis. Although it is impossible to develop strict evidence-based criteria for the selection of one surgical approach over another, some generalizations are possible based on empiric process, anecdotal experience, and published surgical series. Patient selection, cessation of nicotine use, and use of autologous bone graft are factors that influence clinical outcome after lumbar arthrodesis.

Long-term outcomes in multidisciplinary treatment of chronic low back pain: results of a 13-year follow-up.

STUDY DESIGN: Patients completing a multidisciplinary pain treatment were contacted to obtain 13-year follow-up information on pain, mood, employment, and general health. OBJECTIVES: Study objectives were to determine if post-treatment improvements were maintained over a lengthy follow-up period and to compare patients' general health to norms of comparably aged persons. SUMMARY OF BACKGROUND DATA: Although many studies have demonstrated the short-term effectiveness of multidisciplinary pain treatment programs for chronic low back pain, few studies have documented that these treatment gains are maintained over time. Only two studies have reported patient outcomes on a long-term basis (10+ years). Those studies have documented that patient gains during treatment are generally maintained during follow-up. METHODS: An attempt was made to contact all patients completing an inpatient chronic back pain rehabilitation program at the University of Iowa's Spine Diagnostic and Treatment Center. Of the 45 participants, 28 were located and 26 agreed to participate in a telephone interview. Analyses of pretreatment and posttreatment data revealed these follow-up participants did not differ from the larger study sample. RESULTS: Patients maintained their treatment gains in all areas (pain intensity and interference, negative mood). Additionally, patients showed levels of general health comparable to similarly aged peers with the exceptions of pain (more pain) and physical functioning (lower functioning, more pain interference). More than half the sample was employed; of those not employed, few reported this was due to pain. CONCLUSIONS: The data lend support to the long-term effectiveness of multidisciplinary treatment programs for chronic low back pain.