From the Guidelines
For patients with elevated RDQ scores, I recommend starting with nonpharmacologic therapies, specifically spinal manipulation or massage, as they have been shown to have better effects on short-term pain and function compared to other noninvasive interventions 1. The RDQ (Roland-Morris Disability Questionnaire) is a measure of functional status and pain-related disability in patients with low back pain. An elevated RDQ score indicates significant disability and pain that requires treatment. Some key points to consider when treating patients with elevated RDQ scores include:
- Spinal manipulation has been shown to have small to moderate effects on pain and function in patients with chronic low back pain, with some studies suggesting it may be more effective than other noninvasive interventions such as exercise or physical therapy 1.
- Massage has also been shown to have small effects on pain and function in patients with chronic low back pain, although the evidence is not as strong as it is for spinal manipulation 1.
- Acetaminophen and NSAIDs may also be considered for pain management, although the evidence for their effectiveness in improving function is limited 1.
- Digital support interventions, such as web-based programs or mobile apps, may also be useful for self-management of low back pain, although more research is needed to fully understand their effectiveness 1. It's essential to note that the treatment approach should be individualized and based on the patient's specific needs and preferences. A comprehensive treatment plan that includes a combination of nonpharmacologic and pharmacologic therapies, as well as lifestyle modifications, is likely to be the most effective approach for managing elevated RDQ scores and improving patient outcomes 1.
From the Research
Elevated RDQ
- The RDQ (Reflux Disease Questionnaire) is used to diagnose gastroesophageal reflux disease (GERD) 2, 3.
- The questionnaire has been found to have a positive correlation with the severity of reflux esophagitis, and esophageal pH monitoring has shown that patients with abnormal RDQ scores have higher DeMeester scores compared to those with normal RDQ scores 3.
- A study found that taking 12 as the critical RDQ score for GERD achieved a maximal Youden index, with an area under the receiver operating characteristic curve of 0.71, a true positive diagnostic rate of 88.07%, and a true negative diagnostic rate of 68.42% 3.
- However, another study found that the diagnostic value of the RDQ in primary care is limited, but combination with an additional PPI treatment course might improve the RDQ's ability to discriminate GORD patients according to their SAP outcome 2.
- It's worth noting that the RDQ is not directly related to the Roland-Morris Disability Questionnaire (RMDQ), which is used to assess disability in patients with low back pain 4, 5, 6.
- The RMDQ has been found to be a unidimensional measure, and is recommended to be used as such for measuring disability 6.