Predicting the transition from acute to persistent low back pain
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Background: Most people experience low back pain (LBP) at least once in their lifetime. Only a minority of them go on to develop persistent LBP. However, the socioeconomic costs of persistent LBP significantly exceed the costs of the initial acute LBP episode. Aims: To identify factors that influence the progression of acute LBP to the persistent state at an early stage. Methods: Prospective inception cohort study of patients attending a health practitioner for their first episode of acute LBP or recurrent LBP after a pain free period of at least 6 months. Patients were assessed at baseline addressing occupational and psychological factors as well as pain, disability, quality of life and physical activity and followed up at 3, 6, 12 weeks and 6 months. Variables were combined to the three indices 'working condition', 'depression and maladaptive cognitions' and 'pain and quality of life'. Results: The index 'depression and maladaptive cognitions' was found to be a significant baseline predictor for persistent LBP up to 6 months (OR 5.1; 95% CI: 1.04-25.1). Overall predictive accuracy of the model was 81%. Conclusions: In this study of patients with acute LBP in a primary care setting psychological factors at baseline correlated with a progression to persistent LBP up to 6 months. The benefit of including factors such as 'depression and maladaptive cognition' in screening tools is that these factors can be addressed in primary and secondary prevention. © The Author 2011. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved.
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Who is likely to develop persistent low back pain? A longitudinal analysis of prognostic occupational factorsMelloh, Markus; Elfering, A.; Stanton, T.; Käser, A.; Salathé, C.; Barz, T.; Röder, C.; Theis, J. (2013)Objective: Occupational low back pain (LBP) is considered to be the most expensive form of work disability, with the socioeconomic costs of persistent LBP exceeding the costs of acute and subacute LBP by far. This makes ...
Melloh, Markus; Elfering, A.; Chapple, C.; Käser, A.; Salathé, C.; Barz, T.; Röder, C.; Theis, J. (2013)Purpose: To reduce the socio-economic burden of persistent low back pain (LBP), factors influencing the progression of acute/subacute LBP to the persistent state must be identified at an early stage. Methods: Prospective ...