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Trajectories and predictors of the long-term course of low back pain: cohort study with 5-year follow-up

Jordan, KP; Dunn, KM; Strauss, VY; Foster, NE; Chen, Y; Campbell, P

Trajectories and predictors of the long-term course of low back pain: cohort study with 5-year follow-up Thumbnail


Authors

VY Strauss

NE Foster

Y Chen



Abstract

Low back pain (LBP) is a major health challenge globally. Research has identified common trajectories of pain over time. We aimed to investigate whether trajectories described in one primary care cohort can be confirmed in another, and to determine the prognostic value of factors collected 5 years prior to the identification of the trajectory. The study was carried out on 281 patients who had consulted primary care for LBP, at that point completed a baseline questionnaire, and then returned a questionnaire at 5-years follow-up plus at least 3 (of 6) subsequent monthly questionnaires. Baseline factors were measured using validated tools. Pain intensity scores from the 5-year follow-up and monthly questionnaires were used to assign participants into 4 previously derived pain trajectories (no or occasional mild, persistent mild, fluctuating, persistent severe), using latent class analysis. Posterior probabilities of belonging to each cluster were estimated for each participant. The posterior probabilities for the assigned clusters were very high (>0.90) for each cluster except for the smallest 'fluctuating' cluster (0.74). Lower social class and higher pain intensity were significantly associated with a more severe trajectory 5-years later, as were patients' perceptions of the greater consequences and longer duration of pain, and greater passive behavioural coping. LBP trajectories identified previously appear generalizable. These allow better understanding of the long-term course of LBP and effective management tailored to individual trajectories needs to be identified.

Acceptance Date Nov 3, 2017
Publication Date Feb 1, 2018
Publicly Available Date Mar 28, 2024
Journal Pain
Print ISSN 0304-3959
Publisher Lippincott, Williams & Wilkins
Pages 252-260
DOI https://doi.org/10.1097/j.pain.0000000000001097
Publisher URL http://journals.lww.com/pain/Abstract/publishahead/Trajectories_and_predictors_of_the_long_term.99111.aspx

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