Prognosis and course of pain in patients with chronic non-specific low back pain: A 1-year follow-up cohort study
European Journal of Pain , Volume 19 - Issue 8 p. 1101- 1110
Background: It remains unclear to what extent patients recover from chronic non-specific low back pain (NSLBP). The objective of this study was to determine (1) the course of chronic NSLBP in tertiary care and (2) which factors predicted 5- and 12-month outcomes. Methods: This prospective study includes 1760 chronic NSLBP patients from a rehabilitation clinic (mean age 40.1 years, SD 10.6). After baseline measurement, patients followed a 2-month multidisciplinary therapy programme; evaluation took place at 2, 5 and 12 months post baseline. Recovery was defined as (1) relative recovery [30% improvement on the pain, visual analogue scale (VAS) compared with baseline] and (2) absolute recovery (VAS pain ≤ 10 mm). The multivariate logistic regression analysis included 23 baseline characteristics. Results: Patient-reported intensity of back pain decreased from 55.5 (SD 23.0) at baseline to 37.0 (SD 23.8), 35.3 (SD 26.1) and 32.3 (SD 26.9) at 2-, 5- and 12-month follow-up, respectively. Younger age, back pain at baseline, no psychological/physical dysfunction (Symptom Check List-90, item 9), and higher baseline scores on the physical component scale and mental component scale of quality of life (Short Form-36) were positively associated with recovery at 5 and 12 months. At 5-month follow-up, higher work participation at baseline was also a prognostic factor for both definitions of recovery. At 12-month follow-up, having co-morbidity was predictive for both definitions. Conclusion: The results of this study indicate that in chronic NSLBP patients, bio-psychosocial prognostic factors may be important for clinicians when predicting recovery in back pain intensity during a 1-year period.
|European Journal of Pain|
|Organisation||Department of Neuroscience|
Verkerk, K, Luijsterburg, P.A.J, Heymans, M.W, Ronchetti, I, Pool-Goudzwaard, A.L, Miedema, H.S, & Koes, B.W. (2015). Prognosis and course of pain in patients with chronic non-specific low back pain: A 1-year follow-up cohort study. European Journal of Pain, 19(8), 1101–1110. doi:10.1002/ejp.633