Predicting who develops chronic low back pain in primary care: a prospective study.

Abstract:

OBJECTIVES:To quantify the relative contribution of premorbid and episode specific factors in determining the long term persistence of disabling symptoms of low back pain. DESIGN:Prospective cohort study. SETTING:Two general practices in the south Manchester area. PARTICIPANTS:180 patients, who previously participated in a cross sectional population survey, who consulted because of low back pain during the study period. They were followed at 1 week and 3 and 12 months after consultation. MAIN OUTCOME MEASURE:Persistent disabling low back pain in the 12 months after the consultation. RESULTS:Disabling low back pain persisted in one third of participants after consultation and was more common with increasing age, among those with a history of low back pain, and in women. Persistence of symptoms was associated with "premorbid" factors (high levels of psychological distress (odds ratio 3.3; 95% confidence interval 1.5 to 7.2), poor self rated health (3.6; 1.9 to 6.8), low levels of physical activity (2.8; 1.4 to 5.6), smoking (2. 1; 1.0 to 4.3), dissatisfaction with employment (2.4; 1.3 to 4.5)) and factors related to the episode of low back pain (duration of symptoms, pain radiating to the leg (2.6; 1.3 to 5.1), widespread pain (6.4; 2.7 to 15), and restriction in spinal mobility). A multivariate model based on six factors identified groups whose likelihood of persistent symptoms ranged from 6% to 70%. CONCLUSIONS:The presence of persistent low back pain is determined not only by clinical factors associated with pain but also by the premorbid state.

journal_name

BMJ

authors

Thomas E,Silman AJ,Croft PR,Papageorgiou AC,Jayson MI,Macfarlane GJ

doi

10.1136/bmj.318.7199.1662

keywords:

subject

Has Abstract

pub_date

1999-06-19 00:00:00

pages

1662-7

issue

7199

eissn

0959-8138

issn

1756-1833

journal_volume

318

pub_type

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