BACKGROUND: Most people experience low back pain (LBP) at least once in their lifetime. Only a minority of them go on to develop persistent LBP. However, the socioeconomic costs of persistent LBP significantly exceed the costs of the initial acute LBP episode. AIMS: To identify factors that influence the progression of acute LBP to the persistent state at an early stage. METHODS: Prospective inception cohort study of patients attending a health practitioner for their first episode of acute LBP or recurrent LBP after a pain free period of at least 6 months. Patients were assessed at baseline addressing occupational and psychological factors as well as pain, disability, quality of life and physical activity and followed up at 3, 6, 12 weeks and 6 months. Variables were combined to the three indices 'working condition', 'depression and maladaptive cognitions' and 'pain and quality of life'. RESULTS: The index 'depression and maladaptive cognitions' was found to be a significant baseline predictor for persistent LBP up to 6 months (OR 5.1; 95% CI: 1.04-25.1). Overall predictive accuracy of the model was 81%. CONCLUSIONS: In this study of patients with acute LBP in a primary care setting psychological factors at baseline correlated with a progression to persistent LBP up to 6 months. The benefit of including factors such as 'depression and maladaptive cognition' in screening tools is that these factors can be addressed in primary and secondary prevention.
BACKGROUND: Most people experience low back pain (LBP) at least once in their lifetime. Only a minority of them go on to develop persistent LBP. However, the socioeconomic costs of persistent LBP significantly exceed the costs of the initial acute LBP episode. AIMS: To identify factors that influence the progression of acute LBP to the persistent state at an early stage. METHODS: Prospective inception cohort study of patients attending a health practitioner for their first episode of acute LBP or recurrent LBP after a pain free period of at least 6 months. Patients were assessed at baseline addressing occupational and psychological factors as well as pain, disability, quality of life and physical activity and followed up at 3, 6, 12 weeks and 6 months. Variables were combined to the three indices 'working condition', 'depression and maladaptive cognitions' and 'pain and quality of life'. RESULTS: The index 'depression and maladaptive cognitions' was found to be a significant baseline predictor for persistent LBP up to 6 months (OR 5.1; 95% CI: 1.04-25.1). Overall predictive accuracy of the model was 81%. CONCLUSIONS: In this study of patients with acute LBP in a primary care setting psychological factors at baseline correlated with a progression to persistent LBP up to 6 months. The benefit of including factors such as 'depression and maladaptive cognition' in screening tools is that these factors can be addressed in primary and secondary prevention.
Authors: Lisa A Uebelacker; Risa B Weisberg; Debra S Herman; Genie L Bailey; Megan M Pinkston-Camp; Michael D Stein Journal: Pain Med Date: 2015-06-27 Impact factor: 3.750
Authors: Maria Carmen Viana; Carmen C W Lim; Flavia Garcia Pereira; Sergio Aguilar-Gaxiola; Jordi Alonso; Ronny Bruffaerts; Peter de Jonge; Jose Miguel Caldas-de-Almeida; Siobhan O'Neill; Dan J Stein; Ali Al-Hamzawi; Corina Benjet; Graça Cardoso; Silvia Florescu; Giovanni de Girolamo; Josep Maria Haro; Chiyi Hu; Viviane Kovess-Masfety; Daphna Levinson; Marina Piazza; José Posada-Villa; Daniel Rabczenko; Ronald C Kessler; Kate M Scott Journal: J Pain Date: 2017-10-12 Impact factor: 5.820
Authors: Michael D Stein; Debra S Herman; Genie L Bailey; John Straus; Bradley J Anderson; Lisa A Uebelacker; Risa B Weisberg Journal: J Gen Intern Med Date: 2015-02-13 Impact factor: 5.128
Authors: Luciola da C Menezes Costa; Christopher G Maher; Mark J Hancock; James H McAuley; Robert D Herbert; Leonardo O P Costa Journal: CMAJ Date: 2012-05-14 Impact factor: 8.262