The prognostic value of symptom responses in the conservative management of spinal pain: A systematic review

Angeliki G. Chorti, Anastasios G. Chortis, Nikolaos Strimpakos, Christopher J. McCarthy, Sarah E. Lamb

    Research output: Contribution to journalArticlepeer-review


    Study Design. Systematic review. Objective. To investigate the prognostic value of clinically induced changes in spinal symptoms (i.e., symptom response) in the conservative management of spinal pain. Summary of Background Data. Symptom response is used by clinicians to inform management decisions. Understanding the prognostic value of symptom response can aid in this decision-making process. Methods. A search of Ovid-Medline, Ovid-Embase, Ovid-Cinahl, Ovid-Amed, reference lists and citation tracking was performed. Methodologic quality was assessed independently by 2 raters. Results. We included 22 articles reporting 18 different cohorts. The evidence was limited and mainly involved low back pain. We found no association between most symptom responses and clinical outcomes. Only for changes in pain location and/or intensity with repeated spinal movement testing or as a response to treatment did the data provide support for use of symptom response to inform management. Further work is needed to confirm these findings. Limited evidence of an association with disability was found for the prone instability test in low back pain patients attending a stabilization program. The evidence for neurodynamic testing was conflicting for low back pain. The strength of identified associations and the extent of confounding between investigated prognostic factors remain uncertain. Conclusion. Further investigation of symptom respo© 2009, Lippincott Williams & Wilkins.
    Original languageEnglish
    Pages (from-to)2686-2699
    Number of pages13
    Issue number24
    Publication statusPublished - Nov 2009


    • Prognosis
    • Spinal pain
    • Symptom response
    • Systematic review


    Dive into the research topics of 'The prognostic value of symptom responses in the conservative management of spinal pain: A systematic review'. Together they form a unique fingerprint.

    Cite this