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Risk factors for low back pain outcome: Does it matter when they are measured?

BACKGROUND: The early identification of factors that increase risk of poor recovery from acute low back pain (LBP) is critical to prevent the transition to chronicity. Although most studies of risk factors for poor outcome in LBP tend to investigate the condition once it is already persistent, there...

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Autores principales: Klyne, David Murray, Hall, Leanne Marie, Nicholas, Michael K., Hodges, Paul William
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303691/
https://www.ncbi.nlm.nih.gov/pubmed/35090067
http://dx.doi.org/10.1002/ejp.1911
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author Klyne, David Murray
Hall, Leanne Marie
Nicholas, Michael K.
Hodges, Paul William
author_facet Klyne, David Murray
Hall, Leanne Marie
Nicholas, Michael K.
Hodges, Paul William
author_sort Klyne, David Murray
collection PubMed
description BACKGROUND: The early identification of factors that increase risk of poor recovery from acute low back pain (LBP) is critical to prevent the transition to chronicity. Although most studies of risk factors for poor outcome in LBP tend to investigate the condition once it is already persistent, there is evidence to suggest that this differs from risk factors measured during the early‐acute stage. This study aimed to identify early risk factors for poor outcome in the short‐ and long‐term in individuals with acute LBP, and to compare this with factors identified at 3 months in the same cohort. METHODS: One hundred and thirty‐three individuals were recruited within 2 weeks of an acute LBP episode and completed questionnaires related to their sociodemographic, psychological, clinical and history/treatment status at baseline and 3 months later, and their pain‐level fortnightly for 12 months. RESULTS: Of the 133 participants recruited, follow‐up data were provided by 120 at 3 months, 97 at 6 months, 85 at 9 months and 94 at 12 months. Linear regression identified various factors at baseline (acute phase) and 3 months later that predicted short‐ and long‐term outcome (pain level, change in pain). Key findings were that: (1) depressive symptoms at baseline most consistently predicted worse outcome; (2) psychological factors in general at 3 months were more predictive of outcome than when measured at baseline; (3) early health care utilization predicted better outcome, whereas use of pain medication later (3 months) predicted worse outcome; and (4) sex and BMI predicted outcome inconsistently over 12‐months. CONCLUSIONS: The results highlight the multidimensional nature of risk factors for poor outcome in LBP and the need to consider time variation in these factors. SIGNIFICANCE: This study attempts to consider the impact of time variation of candidate risk factors on long‐term outcome from the very early onset of acute low back pain. Risk factors across domains (sociodemographic, psychological, clinical, history/treatment) were identified, but their relationship with outcome often depended on when (acute phase vs. 3 months later) they were measured after back pain onset. Findings highlight the need to consider both a diverse range of factors and their potential time variance when assessing risk of poor outcome.
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spelling pubmed-93036912022-07-28 Risk factors for low back pain outcome: Does it matter when they are measured? Klyne, David Murray Hall, Leanne Marie Nicholas, Michael K. Hodges, Paul William Eur J Pain Original Articles BACKGROUND: The early identification of factors that increase risk of poor recovery from acute low back pain (LBP) is critical to prevent the transition to chronicity. Although most studies of risk factors for poor outcome in LBP tend to investigate the condition once it is already persistent, there is evidence to suggest that this differs from risk factors measured during the early‐acute stage. This study aimed to identify early risk factors for poor outcome in the short‐ and long‐term in individuals with acute LBP, and to compare this with factors identified at 3 months in the same cohort. METHODS: One hundred and thirty‐three individuals were recruited within 2 weeks of an acute LBP episode and completed questionnaires related to their sociodemographic, psychological, clinical and history/treatment status at baseline and 3 months later, and their pain‐level fortnightly for 12 months. RESULTS: Of the 133 participants recruited, follow‐up data were provided by 120 at 3 months, 97 at 6 months, 85 at 9 months and 94 at 12 months. Linear regression identified various factors at baseline (acute phase) and 3 months later that predicted short‐ and long‐term outcome (pain level, change in pain). Key findings were that: (1) depressive symptoms at baseline most consistently predicted worse outcome; (2) psychological factors in general at 3 months were more predictive of outcome than when measured at baseline; (3) early health care utilization predicted better outcome, whereas use of pain medication later (3 months) predicted worse outcome; and (4) sex and BMI predicted outcome inconsistently over 12‐months. CONCLUSIONS: The results highlight the multidimensional nature of risk factors for poor outcome in LBP and the need to consider time variation in these factors. SIGNIFICANCE: This study attempts to consider the impact of time variation of candidate risk factors on long‐term outcome from the very early onset of acute low back pain. Risk factors across domains (sociodemographic, psychological, clinical, history/treatment) were identified, but their relationship with outcome often depended on when (acute phase vs. 3 months later) they were measured after back pain onset. Findings highlight the need to consider both a diverse range of factors and their potential time variance when assessing risk of poor outcome. John Wiley and Sons Inc. 2022-02-07 2022-04 /pmc/articles/PMC9303691/ /pubmed/35090067 http://dx.doi.org/10.1002/ejp.1911 Text en © 2022 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation ‐ EFIC ®. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Klyne, David Murray
Hall, Leanne Marie
Nicholas, Michael K.
Hodges, Paul William
Risk factors for low back pain outcome: Does it matter when they are measured?
title Risk factors for low back pain outcome: Does it matter when they are measured?
title_full Risk factors for low back pain outcome: Does it matter when they are measured?
title_fullStr Risk factors for low back pain outcome: Does it matter when they are measured?
title_full_unstemmed Risk factors for low back pain outcome: Does it matter when they are measured?
title_short Risk factors for low back pain outcome: Does it matter when they are measured?
title_sort risk factors for low back pain outcome: does it matter when they are measured?
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303691/
https://www.ncbi.nlm.nih.gov/pubmed/35090067
http://dx.doi.org/10.1002/ejp.1911
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