Clinical and Psychosocial Factors Over Time Following an Acute Low Back Pain Episode.

ABSTRACT

BACKGROUND: Low back pain (LBP) is a prevalent condition with overwhelming healthcare costs and high disability rates. Characterization of clinical and psychosocial variables over time in patients experiencing an episode of acute LBP and the identification of factors that differ between those who develop chronic LBP and those who do not could aid in the development of improved targeted treatment. PURPOSE: The purpose of this study was to evaluate the trajectory of depression, pain catastrophizing, life purpose, pain sensitivity, and disability in persons presenting with an acute/subacute episode of LBP, evaluating whether there are changes over time and differences in these variables between those who developed chronic LBP and those who did not. METHODS: Prospective analysis (baseline, 2.5 months, 6 months, and weekly diaries) of 42 patients experiencing an acute LBP episode was performed. Descriptive statistics, repeated-measures mixed modeling, and Fisher's least significant differences method were used during data analysis. RESULTS: Depressive symptoms vary over time. There was no difference over time in pain catastrophizing, life purpose, pain sensitivity, or disability. Those who met the criteria for chronic LBP at 6 months had increased pain catastrophizing scores and higher disability scores compared with those who do not meet the criteria for chronic LBP. Depressive symptoms, life purpose, and pain sensitivity were not different between those who met the criteria for chronic LBP and those who did not. CONCLUSION: Findings from this study characterize factors potentially contributory to the development of chronic LBP over time. Those participants who developed chronic LBP had higher pain catastrophizing scores averaged across all time points in this study, suggesting it could be an interesting factor to target to improve LBP chronicity.