Jeff Langmaid explains that back pain labeled as "mild" can still be clinically important when it limits activities of daily living; activity-limiting mild pain predicted later sleep problems even when patients did not report high severity on 0–10 pain scales. He emphasizes assessing functional impact (changes to daily routines, work, leisure) rather than relying solely on subjective numeric pain ratings.
Somebody might not have reported severe back pain but it was activity limiting and therefore that was a really predictive index of what was to come with sleep. So they might have said this is mild but it's activity limiting. On the other side they might have reported severe back pain. However it was not activity limiting and that reduced the likeliness, so to speak, of sleep problems later. So this again it just showcases the fact that one, when we talk about you know what, where are you at on a 0 to 10, that's subjective, right? Pain scales and even when this isn't exactly a pain scale but any back pain, frequent, severe, it's really more important. Is this limiting your activities of daily living? Is this changing the way you do things? Is this limiting the fun you're having? Is this limiting your ability to do your work? Is this limiting? All of these things that are activity limiting are really some of the most important questions that we can be asking.
