Disability in low back pain patients multifactorial

Prolonged Disability Predictors Identified for Low Back Pain
Prolonged Disability Predictors Identified for Low Back Pain

HealthDay News -- Impaired fasting glucose tolerance, greater pain scores, higher BMI and lower quality of life are among several baseline factors that make patients with chronic nonspecific low back pain more likely to report pain-related disability at one year, according to researchers.

"Our study findings highlight the multifactorial complexity of low back pain as a diverse range of factors [...] were significant predictors of poor disability," Philip Wilkens, MChiro, of Oslo University Hospital in Norway, and colleagues reported in Spine.

They conducted a one-year prospective cohort study involving 250 primary care patients, who had chronic nonspecific low back pain that lasted six months or longer and degenerative lumbar osteoarthritis. The researchers assessed potential predictors of pain-related disability at baseline, and analyzed correlations between these factors and outcomes at one year follow up using the Roland Morris Disability Questionnaire.

Fasting glucose levels ≥6.1 mmol/L (95% CI: 1.2 to 6.1, P=0.00), BMI (95% CI: 0.1 to 0.3, P<0.03), and pain-related disability scores (95% CI: 0.1 to 0.4, P=0.00) at baseline were associated with higher pain-related disability scores at one year.

Similarly, QoL was also significantly associated with higher pain-related disability levels at one year, as measured by EuroQoL-index (95% CI: -6.9 to -2.1, P=0.00) and EuroQoL-visual analog scale (95% CI: -0.6 to -0.0; P=0.03).

Imaging findings, modic changes and high-intensity zones were not shown to have any predictive ability.

Wilkens P et al. Spine. 2012; doi: 10.1097/BRS.0b013e318263bb7b.

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