Impact of litigation on quality of life outcomes in patients with chronic low back pain.

Low back pain progresses to chronic low back pain (CLBP) in 5-10 per cent of patients. A Multi-disciplinary Pain Management Programme was tested in 20 patients (m = 4, f = 16). This regime involved psychological and behaviour modification strategies, combined with intensive exercise. Treatment outcome in terms of impairment was assessed by lumbar flexibility, trunk muscle endurance and pain. The disability assessed was exercise fitness and handicap was assessed using the Sickness Impact Profile (SIP) to define the impact of the condition on the patient's life. Overall the patients showed significant improvement (p < 0.05) in all of the measured variables. Patients with on-going litigation however (n = 11) showed no significant improvement in the SIP quality of life score, although they shared the significant improvements attained by the whole group in the domains of impairment (lumbar flexibility, trunk muscle endurance and pain) and disability (exercise fitness).