Racial Differences in Treatment and Outcomes of Chronic Low Back Pain

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2021

Authors

Timmer, Benjamin

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0000-0002-4517-5280 (Timmer, Benjamin)

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Purpose: Chronic low back pain (CLBP) is the leading cause of patient visits to primary care physicians in the United States. Black patients with chronic pain are at higher risk of progressing to disability due to lack of access to healthcare, yet limited studies have addressed the epidemiology of CLBP treatment and outcomes in the Black population. Methods: This cross-sectional study utilized the Pain Registry for Epidemiologic, Clinical, and Interventional Studies and Innovation (PRECISION) to study racial differences in selected patient-reported treatment and clinical outcomes, including a numerical rating scale (NRS) for pain, Roland-Morris Disability Questionnaire, Pain Sensitivity Questionnaire, and Pain Catastrophizing Scale. Results: A total of 848 patients with CLBP participated, including 184 (22%) who were Black. The percentage (95% CI) of Black patients who used non-pharmacological treatments was 70%(63%-77%) vs. 87%(84%-89%) of White patients (p=< 0.001). Black patients were also less likely to use nonsteroidal anti-inflammatory drugs for pain, 72%(65%-78%) vs 86%(83%-89%) (p=< 0.001). However, opioid use was not different between races. Black patients experienced greater pain than White patients based on reported mean (95% CI) NRS values of 7.2(6.9-7.4) vs. 5.8(5.7-5.9) (p=< 0.001). Additionally, Black patients experienced greater disability, pain sensitivity, and pain catastrophizing than White patients (p=< 0.001 for each contrast). Conclusions: These findings suggest that racial health disparities exist among patients with CLBP. Greater efforts to increase awareness of and access to non-pharmacological treatments for Black patients with CLBP may improve their outcomes.

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