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Eur Spine J. 2018 Jan;27(1):136-144. doi: 10.1007/s00586-017-5090-y. Epub 2017 Apr 8.

The association between a lifetime history of low back injury in a motor vehicle collision and future low back pain: a population-based cohort study.

Nolet PS1,2,3, Kristman VL4,5,6,7, Côté P8,6,9,10, Carroll LJ11, Cassidy JD4,6,12.

Author information

1
Department of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada. pnolet@rogers.com.
2
School of Kinesiology, Lakehead University, Thunder Bay, ON, Canada. pnolet@rogers.com.
3
Wellington Orthopaedic and Rehabilitation Associates, 86 Dawson Rd., Unit 3, Guelph, ON, N1H 1A8, Canada. pnolet@rogers.com.
4
Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada.
5
Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada.
6
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
7
Institute for Work and Health, Toronto, ON, Canada.
8
Department of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
9
Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.
10
UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Toronto, ON, Canada.
11
Department of Public Health Sciences, The Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Edmonton, AB, Canada.
12
Department of Sport Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark.

Abstract

PURPOSE:

This population-based cohort study investigated the association between a lifetime history of a low back injury in a motor vehicle collision (MVC) and future troublesome low back pain. Participants with a history of a low back injury in a motor vehicle collision who had recovered (no or mild low back pain) were compared to those without a history of injury. Current evidence from two cross-sectional and one prospective study suggests that individuals with a history of a low back injury in a MVC are more likely to experience future LBP. There is a need to test this association prospectively in population-based cohorts with adequate control of known confounders.

METHODS:

We formed a cohort of 789 randomly sampled Saskatchewan adults with no or mild LBP. At baseline, participants were asked if they had ever injured their low back in a MVC. Six and 12 months later, participants were asked about the presence of troublesome LBP (grade II-IV) on the Chronic Pain Grade Questionnaire. Multivariable Cox proportional hazards regression analysis was used to estimate the association while controlling for known confounders.

RESULTS:

The follow-up rate was 74.8% (590/789) at 6 months and 64.5% (509/789) at 12 months. There was a positive crude association between a history of low back injury in a MVC and the development of troublesome LBP over a 12-month period (HRR = 2.76; 95% CI 1.42-5.39). Controlling for arthritis reduced this association (HRR = 2.25; 95% CI 1.11-4.56). Adding confounders that may be on the casual pathway (baseline LBP, depression and HRQoL) to the multivariable model further reduced the association (HRR = 2.20; 95% CI 1.04-4.68).

CONCLUSION:

Our analysis suggests that a history of low back injury in a MVC is a risk factor for developing future troublesome LBP. The consequences of a low back injury in a MVC can predispose individuals to experience recurrent episodes of low back pain.

KEYWORDS:

Cohort studies; Low back pain; Risk factors; Traffic accidents; Whiplash injuries

PMID:
28391385
DOI:
10.1007/s00586-017-5090-y

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