[Validity of the Mainz Pain Staging System for chronic low back pain : A cross-sectional analysis of inpatient multidisciplinary rehabilitation].

BACKGROUND

Psychological factors have an influence on the manifestation as well as on the maintenance of chronic low back pain (CLBP) and are increasingly considered in research.

OBJECTIVES

The present study investigated the validity and clinical relevance of the Mainz Pain Staging System (MPSS) to replicate previous study results in the setting of inpatient multidisciplinary orthopedic rehabilitation (MOR).

METHODS

In this multicenter study, psychological and pain-related parameters were investigated among 1012 patients with nonspecific CLBP (ICD-10: M51/53/54) at the beginning of an inpatient MOR stratified according to the stage of pain in the MPSS (I-III). In addition, frequency distributions of scores in the clinical range for depression, anxiety, somatization, and pain-related self-efficacy were determined as a function of pain chronification.

RESULTS

Stage of pain had a significant effect on all psychological and pain-related parameters in the expected direction. Alongside patients with stage III, patients with stage II showed higher levels of impairment regarding psychological factors. Furthermore, patients with stage III often had higher clinical scores than expected for depression, anxiety, and somatization.

CONCLUSION

These results confirm the validity and clinical relevance of the MPSS. Moreover, the psychological burden of the patients increased with the stage of pain. Therefore, psychological treatments are required that are tailored to patients' needs. Thus, measurement of the MPSS and psychological diagnostic assessments are recommended.