To determine the outcome of pain conditions

Our knowledge of the natural history of pain syndromes comes from longitudinal studies in which patients'

symptoms and levels of function are documented over time together with risk factors that might affect them. It is important that the measures used are stable and reliable.

For example, patients with back pain who are female, have had long or frequent previous episodes of pain, who exercise less, and who have had a poor initial response to treatment are more likely to be disabled by their pain five years later.1 Studies such as this illustrate the large number of factors that must be controlled in research involving chronic pain. The stakeholders of outcome measurement are summarized in Table 14.1.

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