Prognostic indicators for poor outcomes in low back pain patients consulted in primary care

Abstract

Background Non-specific low back pain (NSLBP) is the most prevalent musculoskeletal condition in western countries and is associated with persistent disability and high consumption of health care resources. NSLBP patients first seek primary health care services but the outcomes are often uncertain. This study aimed to examine the clinical course of the outcomes and to identify prognostic indicators for poor outcomes in NSLBP patients who consulted primary care. Methods A prospective cohort study of 115 patients seeking treatment for NSLBP in primary care was conducted. Participants were consecutively recruited by their General Practitioners (GPs) and then assessed at baseline and 2 and 6 months later. Baseline assessment included socio-demographic and clinical data, psychosocial factors, pain, disability, and health related quality of life (HRQoL). Pain, disability, HRQoL and global perception of change were also assessed at 2 and 6-months' follow-up. In addition, information regarding the GP' practice was collected. Poor outcomes were determined according to the cutoff point used to define a persistent disabling condition and the minimal important change established for disability, pain and for global perception of change. The relationship between variables on baseline and poor outcomes was modulated through binary logistic regression analysis. The significance of associations was evaluated at � 0.05 p-value with 95% confidence intervals (CI) and adjusted odds ratios (AOR). Results 110 (94.8%) and 104 (89.7%) participants completed the follow-up assessment at 2 and 6 months, respectively. The mean age (±SD) was 48.06 ± 11.41, with 53.9%, (N = 62)

Predictors of response following standardized education and self-management recommendations for low back pain stratified by dominant pain location

“…Consistent with what has previously been reported, we found worse baseline disability scores were associated with greater likelihood of response, [41] , [42] , [43] while smoking and longer pain duration were associated with poorer outcome. [ 12 , [43] , [44] , [45] , [46] , [47] , [48] , [49] ] Longer pain duration (6+ months vs. <3 months) was similarly associated with poorer outcome for the back- and leg-dominant pain groups.…”

Does the Keele STarT Back Screening Tool Contribute to Effectiveness in Treatment and Cost and Loss of Follow-Up of the Mechanical Diagnosis and Therapy for Patients with Low Back Pain?

“…MDT management strategies are individualized by considering biopsychosocial perspectives, which may correct abnormal cognitive processing for pain and psychological status that disturbs recovery from LBP (yellow-frags) [ 14 , 15 ]. In addition, the effectiveness of MDT in the population with chronic LBP has been established in a recent systematic review [ 16 ], who are likely to have some yellow-frags [ 17 , 18 ]. In MDT, there are three primary subgroups for the spinal problem, and the inter-examiner reliability for the subgroups has been established among credentialed MDT therapists [ 19 ].…”

Digital Rehabilitation for Acute Low Back Pain: A Prospective Longitudinal Cohort Study

“…All subgroups had similar demographic characteristics, except for sex (p = 0.016), BMI (p = 0.029), and pain radiating to lower limb (p = 0.020), with males and those with lower BMI and without radiating pain to lower limb reporting lower pain levels at baseline. Despite the existence of referred leg pain being reported as a poorer prognostic factor, 12 , 13 , 72 herein no significant improvement differences were observed between participants with or without radiating pain, with the exception of WPAI activity, with higher improvement observed in those with radiating pain ( Supplementary Table S7 ).…”