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Predicting Future Episodes of Back Pain

Back pain. Who's at risk? Is it a physical or psychologic problem? That's the focus of this study from Stanford Medical School in California. Doctors know the biggest risk factor for chronic low back pain (LBP) is a previous bout of LBP. Is this because the spine is degenerating in these adults? Or are psychosocial factors such as depression more important?

One-hundred (100) adults with known mild back pain were studied. No one was disabled by pain. Everyone was contacted every six months for five years. The goal was to find risk factors that predict who will get back pain again.

The condition of the spine was monitored using a physical exam, MRIs, and studies of the lumbar discs. Questions were asked about number of days missed at work, pain levels, and number of medical visits.

The authors report that structural changes in the spine did not increase risk of future back problems. Psychosocial factors were strongly linked to both short-term and long-term disability. Worker's compensation claims, heavy work, and fear of injury were most closely linked with future back pain.

The results of this study support psychosocial variables as a better predictor of who will need future medical care for episodes of back pain.

References: Eugene J. Carragee, MD, et al. Discographic, MRI and Psychosocial Determinants of Low Back Pain Disability and Remission: A Prospective Study in Subjects with Benign Persistent Back Pain. In The Spine Journal. January/February 2005. Vol. 5. No. 1. Pp. 24-35.

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