When healing is temporally complete, but biomechanically imperfect, leading to permanent impairment of supporting elements, chronic disability may follow. It is exceedingly important to educate patients to understand the importance of and participation in a functional recovery program. 774 back and neck pain patients treated at specialty spine clinics that patients with back pain and neck pain perceived themselves to have greater functional impairment than typical patients with cancer, diabetes, congestive heart failure, myocardial infarction, and hypertension. In other words, if we are not evaluating and quantifying our patients' functional impairment, we are not adequately representing the severity and nature of their health problems, and are missing the most important characteristic of the case - the disability. The restoration of function, so that a patient has an adequate capacity to tolerate activities of daily living and work tasks, is the single most important goal of care.
Patients invariably expect treatment to result in pain-free status.
Instead, it should be stressed that recovery of function is the primary goal. This is the thrust of the findings and the conclusion of many international guidelines. The actual treatment relates to regaining activity tolerance. Controlling symptoms supports, not replaces, the true treatment. The Back Pain Revolution.