Predictors for Long-Term Back Pain and Disability Evaluated

Disability, pain at one year linked to baseline disability and pain, anxiety, diffuse tenderness
By Jeff Muise
HealthDay Reporter

WEDNESDAY, July 28 (HealthDay News) -- For patients who miss work with low back pain (LBP), persistent disability and pain one year after treatment are associated with baseline pain intensity and degree of disability, diffuse tenderness, health anxiety and fear avoidance, little or moderate exercise, and having made a compensation claim, according to a study in the August issue of The Spine Journal.

Ole Kudsk Jensen, M.D., of the Region Hospital Silkeborg in Denmark, and colleagues followed 325 patients who missed work for three to 16 weeks because of LBP, and who previously had undergone baseline examinations and completed surveys on pain, disability, and mental health in an LBP study. The researchers surveyed the subjects again at one year and evaluated disability, pain, and other factors to see what baseline factors predicted long-term disability, pain, and return to work (RTW).

The researchers found that the predictors for disability and back plus leg pain at one year were baseline intensity of back plus leg pain, health anxiety and worry, diffuse tenderness, and little or moderate exercise. In patients with radiculopathy, there were two additional risk factors: "drinking alcohol less than once per month" and older age. Disability was also associated with having made a compensation claim, and back plus leg pain was associated with pain duration and fear avoidance about physical activity. Change in disability was more closely linked to RTW than alteration in pain.

"The present study confirmed the importance of well-known risk factors for future disability and pain, such as high initial disability, high intensity of back+leg pain, worrying and health anxiety, compensation claim, and fear avoidance about physical activity," the authors write.

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