Low back pain risk factors associated with persistence, recurrence and delayed presentation

Abstract

Background: There is little knowledge in the literature on the role of time-related variables for the prognosis of acute and subacute low back pain (LBP).

Objective: The aim of this study was to estimate the relationship between time-related LBP characteristics and prognostic factors for acute/subacute LBP.

Methods: We performed a prospective inception cohort study of 315 patients attending a health practitioner for acute/subacute LBP or recurrent LBP. One-tailed correlations were conducted between patient characteristics and time-related variables.

Results: The pattern of correlation between risk factors for and resources against persistent LBP differed between three time-related variables. 'Subacute LBP' and 'delayed presentation' were positively associated with psychological factors. Both indicators were negatively correlated with resources against development of persistent LBP. Moreover, 'delayed presentation' was related positively with occupational stressors. In contrast, 'recurrent LBP' was only related to more impaired health-related factors.

Conclusions: Patients with current LBP waiting longer until seeking help in primary care have a more disadvantageous profile of occupational and psychological risk factors and lower resource levels. A similar but less pronounced pattern occurred in those with subacute LBP compared to those with acute LBP. Consideration of time characteristics of LBP may help to better understand LBP.

Keywords: Back pain; inception cohort; occupational; prognosis; resources; risk factors.