Gustavo C Machado1, Chris G Maher2, Paulo H Ferreira3, Jane Latimer2, Bart W Koes4, Daniel Steffens5, Manuela L Ferreira6. 1. School of Public Health, The University of Sydney, PO Box M179, Missenden Rd, Camperdown, NSW 2050 Australia. 2. School of Public Health, The University of Sydney, Sydney, Australia. 3. Faculty of Health Sciences, The University of Sydney, Sydney, Australia. 4. Department of General Practice, Erasmus Medical Centre, Rotterdam, the Netherlands. 5. Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, Australia. 6. Institute of Bone and Joint Research, Sydney Medical School, The University of Sydney, Sydney, Australia.
Abstract
BACKGROUND: Although recurrence is common after an acute episode of low back pain, estimates of recurrence rates vary widely and predictors of recurrence remain largely unknown. OBJECTIVE: The purposes of the study were to determine the 1-year incidence of recurrence in participants who recovered from an acute episode of low back pain and to identify predictors of recurrence. DESIGN: The design was an inception cohort study nested in a case-crossover study. METHODS: For 12 months, 832 of the 999 participants who initially presented to primary care within the first 7 days of an episode of low back pain were followed. Of these participants, 469 recovered (1 month pain free) from the index episode within 6 weeks and were included in this study. Recurrence was defined as a new episode lasting more than 1 day, or as an episode of care seeking. Putative predictors were assessed at baseline and chosen a priori. Multivariable regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: The 1-year incidence of recurrence of low back pain was 33%, and the 1-year incidence of recurrence of low back pain with care seeking was 18%. Participants reporting more than 2 previous episodes of low back pain had increased odds of future recurrences (OR = 3.18, CI = 2.11-4.78). This factor was also associated with recurrent episodes that led to care seeking (OR = 2.87, CI = 1.73-4.78). No other factors were associated with recurrences. LIMITATIONS: There are limitations inherent in reliance on recall. CONCLUSIONS: After an acute episode of low back pain, one-third of patients will experience a recurrent episode, and approximately half of those will seek care. Experiencing more than 2 previous episodes of low back pain triples the odds of a recurrence within 1 year.
BACKGROUND: Although recurrence is common after an acute episode of low back pain, estimates of recurrence rates vary widely and predictors of recurrence remain largely unknown. OBJECTIVE: The purposes of the study were to determine the 1-year incidence of recurrence in participants who recovered from an acute episode of low back pain and to identify predictors of recurrence. DESIGN: The design was an inception cohort study nested in a case-crossover study. METHODS: For 12 months, 832 of the 999 participants who initially presented to primary care within the first 7 days of an episode of low back pain were followed. Of these participants, 469 recovered (1 month pain free) from the index episode within 6 weeks and were included in this study. Recurrence was defined as a new episode lasting more than 1 day, or as an episode of care seeking. Putative predictors were assessed at baseline and chosen a priori. Multivariable regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: The 1-year incidence of recurrence of low back pain was 33%, and the 1-year incidence of recurrence of low back pain with care seeking was 18%. Participants reporting more than 2 previous episodes of low back pain had increased odds of future recurrences (OR = 3.18, CI = 2.11-4.78). This factor was also associated with recurrent episodes that led to care seeking (OR = 2.87, CI = 1.73-4.78). No other factors were associated with recurrences. LIMITATIONS: There are limitations inherent in reliance on recall. CONCLUSIONS: After an acute episode of low back pain, one-third of patients will experience a recurrent episode, and approximately half of those will seek care. Experiencing more than 2 previous episodes of low back pain triples the odds of a recurrence within 1 year.
Authors: Emma K Ho; Manuela L Ferreira; Adrian Bauman; Paul W Hodges; Christopher G Maher; Milena Simic; Rachael L Morton; Chris Lonsdale; Qiang Li; Melissa T Baysari; Anita B Amorim; Dragana Ceprnja; Ornella Clavisi; Mark Halliday; Matthew Jennings; Alice Kongsted; Katherine Maka; Kate Reid; Tahlia Reynolds; Paulo H Ferreira Journal: BMC Musculoskelet Disord Date: 2021-07-09 Impact factor: 2.362