J Manipulative Physiol Ther. 1990 Oct; 13(8): 437-47.

A comparison of low back pain profiles of chiropractic teaching clinic patients with patients attending private clinicians.

Nyiendo J.

Western States Chiropractic College, Portland, OR 97230.

A study was undertaken at six chiropractic college outpatient (teaching) clinics and 60 private chiropractic clinics, to evaluate the comparability of patients' pain quality and pain intensity in each of three low back pain diagnostic groups. The McGill Pain Questionnaire (MPQ) was employed for this purpose. There was a tremendous range of measurable pain characteristics (Pain Rating Index scores) within the three diagnostic groups in both patient samples. Overall, patients of field doctors had higher mean scores on all dimensions of pain quality measured by the MPQ, and they described a higher pain intensity than patients attending the teaching clinics. In all three diagnostic groups, patients attending teaching clinics were more likely than private patients to present with a chronic low back condition. Although patients in the field more frequently used words implying greater pain intensity, the characteristics of pain quality (descriptor profiles) showed similar trends among the two patient samples. The consistent findings of less pain intensity among teaching clinic patients support previous reports that these patients have milder complaints than patients seen by field doctors. While these findings do not rule out the use of teaching clinic patients as subjects in clinical trials, it is suggested that generalizations from teaching clinic patients to private patients should be made with caution.