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Phys Ther. 2017 Sep 1;97(9):889-895. doi: 10.1093/ptj/pzx067.

Can Recurrence After an Acute Episode of Low Back Pain Be Predicted?

Author information

1
School of Public Health, The University of Sydney, PO Box M179, Missenden Rd, Camperdown, NSW 2050 Australia.
2
School of Public Health, The University of Sydney, Sydney, Australia.
3
Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
4
Department of General Practice, Erasmus Medical Centre, Rotterdam, the Netherlands.
5
Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, Australia.
6
Institute of Bone and Joint Research, Sydney Medical School, The University of Sydney, Sydney, Australia.

Abstract

Background:

Although recurrence is common after an acute episode of low back pain, estimates of recurrence rates vary widely and predictors of recurrence remain largely unknown.

Objective:

The purposes of the study were to determine the 1-year incidence of recurrence in participants who recovered from an acute episode of low back pain and to identify predictors of recurrence.

Design:

The design was an inception cohort study nested in a case-crossover study.

Methods:

For 12 months, 832 of the 999 participants who initially presented to primary care within the first 7 days of an episode of low back pain were followed. Of these participants, 469 recovered (1 month pain free) from the index episode within 6 weeks and were included in this study. Recurrence was defined as a new episode lasting more than 1 day, or as an episode of care seeking. Putative predictors were assessed at baseline and chosen a priori. Multivariable regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI).

Results:

The 1-year incidence of recurrence of low back pain was 33%, and the 1-year incidence of recurrence of low back pain with care seeking was 18%. Participants reporting more than 2 previous episodes of low back pain had increased odds of future recurrences (OR = 3.18, CI = 2.11-4.78). This factor was also associated with recurrent episodes that led to care seeking (OR = 2.87, CI = 1.73-4.78). No other factors were associated with recurrences.

Limitations:

There are limitations inherent in reliance on recall.

Conclusions:

After an acute episode of low back pain, one-third of patients will experience a recurrent episode, and approximately half of those will seek care. Experiencing more than 2 previous episodes of low back pain triples the odds of a recurrence within 1 year.

PMID:
28969347
DOI:
10.1093/ptj/pzx067
[Indexed for MEDLINE]

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