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Review
. 2021 Apr 1;6(1):e919.
doi: 10.1097/PR9.0000000000000919. eCollection 2021.

Prognostic factors for pain chronicity in low back pain: a systematic review

Linda Karoliina Nieminen  1 , Liisa Maria Pyysalo  1 , Markku Juhani Kankaanpää  1   2
Affiliations
Review

Prognostic factors for pain chronicity in low back pain: a systematic review

Linda Karoliina Nieminen et al. Pain Rep. .

Abstract

Low back pain is the leading cause for years lived in disability. Most people with acute low back pain improve rapidly, but 4% to 25% of patients become chronic. Since the previous systematic reviews on the subject, a large number of new studies have been conducted. The objective of this article was to review the evidence of the prognostic factors behind nonspecific chronic low back pain. A systematic literature search was performed without date limitation from the MEDLINE, Cochrane library, and Medic databases. Specific inclusion criteria were used, and risk factors before the onset of chronic symptoms were searched. Study quality was assessed by 2 independent reviewers. One hundred eleven full articles were read for potential inclusion, and 25 articles met all the inclusion criteria. One study was rated as good quality, 19 studies were rated as fair quality, and 5 articles were rated as poor quality. Higher pain intensity, higher body weight, carrying heavy loads at work, difficult working positions, and depression were the most frequently observed risk factors for chronic low back pain. Maladaptive behavior strategies, general anxiety, functional limitation during the episode, smoking, and particularly physical work were also explicitly predictive of chronicity. According to this systematic review, several prognostic factors from the biomechanical, psychological and psychosocial point of view are significant for chronicity in low back pain.

Keywords: Chronic pain; Low back pain; Nonspecific; Prognostic factors; Risk factors.

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Conflict of interest statement

The authors have no conflicts of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
Prisma flow diagram of the study selection process.
See this image and copyright information in PMC

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