Trajectories and predictors of the long-term course of low back pain: cohort study with 5-year follow-up

Chen, Ying; Campbell, Paul; Strauss, Victoria Y; Foster, Nadine E; Jordan, Kelvin P.; Dunn, Kate M.

doi:10.1097/j.pain.0000000000001097

Cited by 108 publications

(113 citation statements)

References 40 publications

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“…These findings are somewhat paradoxical since some of the risk factors that were associated with persistent and developing back pain were also linked to recovery from back pain. Future studies, including established psychological risk factors of back pain, such as low mood and pain somatization, are warranted .…”

Section: Discussionmentioning

confidence: 99%

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Course of Back Pain in the Canadian Population: Trajectories, Predictors, and Outcomes

Cañizares

Rampersaud

Badley

2019

Arthritis Care & Research

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Objective. To identify and describe back pain trajectory groups and to compare indicators of health status, medication, and health care use in these groups.Methods. A representative sample (n = 12,782) of the Canadian population was followed-up from 1994/1995 to 2010/2011. Participants were interviewed biannually and provided data on sociodemographic (e.g., education) and behavior-related (e.g., physical activity) factors, depression, comorbidities, pain, disability, medication use (e.g., opioids), and health care use (e.g., primary care visits). We used group-based trajectory analysis to categorize participants according to patterns in the course of their back pain during the 16-year follow-up period and compared indicators of pain, disability, medication, and health care use in the trajectory groups.Results. A total of 45.6% of the participants reported back pain at least once during follow-up. Of those, we identified 4 trajectories: persistent (18.0%), developing (28.1%), recovery (20.5%), and occasional (33.4%). The persistent and developing groups were characterized as having pain that prevented activities, disability, depression, and comorbidities. There were significant differences in the patterns of medication and health care use across the groups, with a general trend of most to least health care and medication use in the persistent, developing, recovering, and occasional groups. Those in the recovery group had an increasing trajectory reflecting opioid and antidepressant use.Conclusion. Approximately 1 in 5 people with back pain experience a persistent pain trajectory with an associated increase in pain, disability, and health care use. Further research is needed to determine whether the groups identified represent different diagnoses, which may provide insight into the selection of stratified treatment and aid in designing early prevention and management strategies in the population.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies have examined the trajectories of back pain . The majority of these involved patients who presented to primary care settings with back pain , had a restricted age range , and/or had short follow‐up times (≤1 year) . Only a few studies have examined back pain in the general population using a wide age range .…”

Section: Introductionmentioning

confidence: 99%

Course of Back Pain in the Canadian Population: Trajectories, Predictors, and Outcomes

Cañizares

Rampersaud

Badley

2019

Arthritis Care & Research

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“…There has been a recent review looking at the long-term prognosis in persistent low back pain. 7 It revealed that patients from a primary care cohort with persistent low back pain do not have widely fluctuating pain. Rather, they tend to have ongoing pain that varies only slightly around their own mean long-term pain.…”

Section: Discussionmentioning

confidence: 99%

Interdisciplinary spinal pain clinics in primary care: Outcomes from one service

Masters

Hogarth

2019

Aust J Gen Pract

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“…Исход болевого синдрома значительно различается между отдельными пациентами [5; 6] и остается трудным для точного прогнозирования, несмотря на значительное количество опубликованных исследований [7]. К основным прогностическим факторам, влияющим на течение БНЧС, относят: социально-демографические, такие как уровень образования, возраст и пол пациента; физические факторы, такие как интенсивность боли и продолжительность нетрудоспособности; психологические факторы, такие как наличие депрессии, тревоги и страха, связанного с передвижением, и профессиональные факторы [8][9][10][11]. Некоторые авторы считают БНЧС нейроиммунным расстройством с вовлечением глиальных клеток и различных цитокинов [12; 13].…”

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The Possibility of Prediction of Acute Non-Specific Low Back Pain Using Serum Autoantibodies

Карпов¹,

Simkhes²,

Baturin³

2020

СПНО (MPSE)

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Проведено комплексное клинико-неврологическое и иммунологическое исследование трудоспособных пациентов с острой неспецифической болью в нижней части спины и оценка эффективности проведенного стандартного лечения. Первую группу сравнения составили 27 больных с острой болью в нижней части спины продолжительностью боли менее 14 дней, во вторую группу включены 24 пациента с острой болью в нижней части спины сроком более двух недель. Обе группы были сопоставимы по возрасту, полу и нейровизуализационным данным. В первый день лечения изучались в сыворотке крови уровни аутоантител к белкам S-100 и миозину, в последний день лечения оценивался исход заболевания по шкале The Low-Back Outcome Scale (LBOS). На первом этапе статистической обработки проводился ранговый дисперсионный анализ Краскела-Уоллиса, затем с помощью непараметрического критерия Манна-Уитни проведено попарное сравнение различных исходов заболевания с учетом длительности обострения болевого синдрома. Данные обрабатывались при помощи программного обеспечения «SPSS 26.0». Результаты изучения уровня аутоантител к белкам S-100 и миозину показали статистически значимую связь высоких значений данных показателей с неудовлетворительным исходом острой боли в нижней части спины независимо от ее продолжительности. Полученные данные полезно учитывать при прогнозировании острой боли в нижней части спины, что потенциально позволит скоординировать лечебно-профилактические мероприятия.Ключевые слова: неспецифическая боль в спине, аутоантитела, белок S-100, миозин. A comprehensive clinical, neurological and immunological study of able-bodied patients with acute nonspecific low back pain was conducted and the effectiveness of the standard treatment was evaluated. The first comparison group consisted of 27 patients with acute low back pain with a duration of pain less than 14 days, the second group included 24 patients with acute low back pain for a period of more than two weeks. Both groups were comparable by age, gender, and neuroimaging data. On the first day of treatment, serum levels of autoantibodies to S-100 and myosin proteins were studied, and on the last day of treatment, the outcome of the disease was assessed according to The Low-Back Outcome Scale (LBOS). At the first stage of statistical processing, the Kruskal -Wallis rank analysis was performed, then, using the non-parametric Mann-Whitney criterion, a pairwise comparison of various outcomes of the disease was carried out taking into account the duration of the exacerbation of the pain syndrome. Data was processed using the SPSS 26.0 software. The results of a study of the level of autoantibodies to S-100 and myosin proteins showed a statistically significant relationship between the high values of these indicators and the unsatisfactory outcome of acute low back pain regardless of its duration. The obtained data is useful to take into account when predicting acute low back pain, which will potentially coordinate the treatment and preventive measures.

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Trajectories and predictors of the long-term course of low back pain: cohort study with 5-year follow-up

Abstract: Supplemental Digital Content is Available in the Text.Low back pain trajectories identified previously appear generalizable. Effective management tailored to individual trajectories needs to be identified.

Cited by 108 publications

References 40 publications

Course of Back Pain in the Canadian Population: Trajectories, Predictors, and Outcomes

Course of Back Pain in the Canadian Population: Trajectories, Predictors, and Outcomes

Interdisciplinary spinal pain clinics in primary care: Outcomes from one service

The Possibility of Prediction of Acute Non-Specific Low Back Pain Using Serum Autoantibodies

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