Are prognostic indicators for poor outcome different for acute and chronic low back pain consulters in primary care?
Open accessAbstract
Few studies have investigated whether prognostic indicators, which contribute to the transition from acute to chronic low back pain (LBP), are also those which contribute to continuing persistence of chronic LBP. We compared the contribution of physical, psychological and social indicators to predicting disability after one year between consulters with LBP of less than 3 months duration and more than 3 months duration. Data from two large prospective cohort studies of consecutive patients consulting with LBP in general practices were merged, providing complete data for 258 cases with acute/subacute LBP and 668 cases with chronic LBP at 12 months follow-up. There were significant differences between the two LBP groups in baseline characteristics and clinical course of disability, assessed by Roland Morris Disability Questionnaire, during the year of follow-up. Adjusted associations between potential prognostic indicators and disability at 12months were carried out in the two LBP subgroups. The final multivariable regression models showed that being non-employed, having widespread pain, a high level of Chronic Pain Grade, and catastrophising were the strongest prognostic indicators for disability at 12 months in both LBP groups. Fear of pain was significantly associated with disability in chronic LBP. Importantly, beyond baseline disability, the effect size of the other prognostic indicators for poor outcome was rather low. These findings must continue to challenge researchers to identify useful early predictors of outcome in persons with disabling back pain, as screening and targeted treatment approaches are dependent upon prognostic indicators with clinical significance.
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Kinesiophobia is a strong predictor for long-term pain disability and pain chronicity, and is associated with higher rates of sick leave, pain vigilance, disability, and decreased physical activity.
“It has been demonstrated that kinesiophobia has shown to be a strong predictor for pain disability and pain chronicity in the longer term [73] associated with higher rates of sick-leaves [74], pain vigilance and disability as well as decreased physical activity levels [75–77].”
From Chronic pain and sex-differences; women accept and move, while men feel blue (2017) · cites this paper as [73]
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Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139 · see citing works
Depression and quality of life in older persons: A review
Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A.-S. (2015) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000437299 · Cited by 14,152 · see citing works
A Study of the Natural History of Back Pain: Part I
ROLAND, M., & MORRIS, R. (1983) · Spine · doi:10.1097/00007632-198303000-00004 · Cited by 3,395 · cited 1× · see citing works
“Self-reported disability due to LBP was measured by the Roland and Morris Disability Questionnaire (RDQ) [34], which has 24 items, scored from 0 (no disability) to 24 (highest disability).”
MethodGrading the severity of chronic pain
Von Korff, M., Ormel, J., Keefe, F. J., & Dworkin, S. F. (1992) · Pain · doi:10.1016/0304-3959(92)90154-4 · Cited by 3,022 · see citing works
Chapter 4 European guidelines for the management of chronic nonspecific low back pain
Airaksinen, O., Brox, J. I., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., Mannion, A. F., Reis, S., Staal, J. B., Ursin, H., et al. (2006) · European Spine Journal · doi:10.1007/s00586-006-1072-1 · Cited by 2,594 · see citing works
Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care
van Tulder, M., Becker, A., Bekkering, T., Breen, A., del Real, M. T. G., Hutchinson, A., Koes, B., Laerum, E., Malmivaara, A., & On behalf of the COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care (2006) · European Spine Journal · doi:10.1007/s00586-006-1071-2 · Cited by 1,258 · see citing works
Outcome Measures for Low Back Pain Research: A Proposal for Standardized Use
Deyo, R. A., Battie, M., Beurskens, A. J. H. M., Bombardier, C., Croft, P., Koes, B., Malmivaara, A., Roland, M., Von Korff, M., & Waddell, G. (1998) · Spine · doi:10.1097/00007632-199809150-00018 · Cited by 1,229 · see citing works
Self-citationKinesiophobia : a new view of chronic pain behavior
Kori, S. (1990) · Medical Entomology and Zoology · Cited by 1,040 · see citing works
Standard occupational classification
Surveys (1990) · HMSO eBooks · Cited by 963 · see citing works
Pain Catastrophizing and Kinesiophobia: Predictors of Chronic Low Back Pain
Picavet, H. S. J. (2002) · American Journal of Epidemiology · doi:10.1093/aje/kwf136 · Cited by 744 · see citing works
Psychosocial Predictors of Outcome in Acute and Subchronic Low Back Trouble
Burton, A. K., Tillotson, K. M., Main, C. J., & Hollis, S. (1995) · Spine · doi:10.1097/00007632-199503150-00014 · Cited by 700 · cited 1× · see citing works
“Our findings, along with other findings in samples with acute LBP [2,5,6,21,36] suggest that early screening and targeted treatment should be considered regardless of pain duration.”
ResultHenschke, N., Maher, C. G., Refshauge, K. M., Herbert, R., Cumming, R. G., Bleasel, J. F., York, J., Das, A., & McAuley, J. H. (2008) · BMJ · doi:10.1136/bmj.a171 · Cited by 555 · see citing works
Predicting who develops chronic low back pain in primary care: a prospective study
Thomas, E., Silman, A. J., Croft, P. R., Papageorgiou, A. C., Jayson, M. I. V., & Macfarlane, G. J. (1999) · BMJ · doi:10.1136/bmj.318.7199.1662 · Cited by 499 · see citing works
Self-citationA Study of the Natural History of Low-Back Pain
Roland, M. O., & Morris, R. W. (1983) · Spine · doi:10.1097/00007632-198303000-00005 · Cited by 462 · see citing works
Prognosis for patients with chronic low back pain: Inception cohort study
Costa, L. D. C. M., Maher, C. G., McAuley, J. H., Hancock, M. J., Herbert, R. D., Refshauge, K. M., & Henschke, N. (2009) · BMJ · doi:10.1136/bmj.b3829 · Cited by 430 · see citing works
Lithwick, A., Lev, S., & Binshtok, A. (2013) · Pain Management · doi:10.2217/pmt.12.74 · Cited by 420 · see citing works
Coste, J., Delecoeuillerie, G., Lara, A. C. D., Parc, J. M. L., & Paolaggi, J. B. (1994) · BMJ · doi:10.1136/bmj.308.6928.577 · Cited by 416 · see citing works
Korff, M. V., Deyo, R. A., Cherkin, D. C., & Barlow, W. E. (1993) · Spine · doi:10.1097/00007632-199306000-00008 · Cited by 403 · see citing works
Characterizing the Course of Low Back Pain: A Latent Class Analysis
Dunn, K. M., Jordan, K. P., & Croft, P. R. (2006) · American Journal of Epidemiology · doi:10.1093/aje/kwj100 · Cited by 355 · see citing works
Self-citationPrognostic factors for musculoskeletal pain in primary care: a systematic review.
(2007) · PubMed Central · Cited by 349 · see citing works
Episodes of low back pain: a proposal for uniform definitions to be used in research.
de Vet, H. C. W., Heymans, M. W., Dunn, K. M., Pope, D. P., van der Beek, A. J., Macfarlane, G. J., Bouter, L. M., & Croft, P. R. (2002) · PubMed · doi:10.1097/01.brs.0000030307.34002.be · Cited by 331 · see citing works
Self-citationDistinctiveness of psychological obstacles to recovery in low back pain patients in primary care
Foster, N. E., Thomas, E., Bishop, A., Dunn, K. M., & Main, C. J. (2009) · Pain · doi:10.1016/j.pain.2009.11.002 · Cited by 325 · see citing works
Self-citationde Vet, H. C. W., Heymans, M. W., Dunn, K. M., Pope, D. P., van der Beek, A. J., Macfarlane, G. J., Bouter, L. M., & Croft, P. R. (2002) · Spine · doi:10.1097/00007632-200211010-00016 · Cited by 319 · see citing works
Self-citationOccupational Psychological Factors Increase the Risk for Back Pain: A Systematic Review
LINTON, S. J. (2001) · Journal of Occupational Rehabilitation · doi:10.1023/a:1016656225318 · Cited by 288 · see citing works
Foster, N. E., Bishop, A., Thomas, E., Main, C. J., Horne, R., Weinman, J. A., & Hay, E. M. (2008) · Pain · doi:10.1016/j.pain.2007.12.007 · Cited by 276 · see citing works
Self-citationRisk Factors Associated With the Transition From Acute to Chronic Occupational Back Pain
Fransen, M., Woodward, M., Norton, R., Coggan, C. A., Dawe, M., & Sheridan, N. (2002) · Spine · doi:10.1097/00007632-200201010-00022 · Cited by 267 · see citing works
Fear avoidance and prognosis in back pain: A systematic review and synthesis of current evidence
Pincus, T., Vogel, S. K., Burton, K. A., Santos, R., & Field, A. P. (2006) · Arthritis & Rheumatism · doi:10.1002/art.22273 · Cited by 259 · see citing works
Carey, T. S., Garrett, J. M., & Jackman, A. (2000) · Spine · doi:10.1097/00007632-200001010-00019 · Cited by 224 · see citing works
Von Korff, M., & Dunn, K. M. (2008) · Pain · doi:10.1016/j.pain.2007.12.010 · Cited by 205 · see citing works
Self-citationRohling, M. L., Binder, L. M., & Langhinrichsen‐Rohling, J. (1995) · Health Psychology · doi:10.1037//0278-6133.14.6.537 · Cited by 205 · see citing works
Dunn, K. M., & Croft, P. R. (2005) · Spine · doi:10.1097/01.brs.0000173900.46863.02 · Cited by 204 · see citing works
Self-citationCan we predict poor recovery from recent-onset nonspecific low back pain? A systematic review
Kent, P. M., & Keating, J. L. (2007) · Manual Therapy · doi:10.1016/j.math.2007.05.009 · Cited by 185 · see citing works
Macfarlane, G. J., Thomas, E., Croft, P. R., Papageorgiou, A. C., Jayson, M. I. V., & Silman, A. J. (1999) · Pain · doi:10.1016/s0304-3959(98)00209-7 · Cited by 166 · see citing works
Self-citationThe Transition from Acute to Subacute and Chronic Low Back Pain
Kovacs, F. M., Abraira, V., Zamora, J., & Fernández, C. (2005) · Spine · doi:10.1097/01.brs.0000172159.47152.dc · Cited by 163 · see citing works
Clinical Course and Impact of Fear-Avoidance Beliefs in Low Back Pain
Grotle, M., Vøllestad, N. K., & Brox, J. I. (2006) · Spine · doi:10.1097/01.brs.0000214878.01709.0e · Cited by 161 · see citing works
Self-citationThe Prognosis of Low Back Pain in General Practice
van den Hoogen, H. J. M., Koes, B. W., Devillé, W. L. J. M., van Eijk, J. T. M., & Bouter, L. M. (1997) · Spine · doi:10.1097/00007632-199707010-00019 · Cited by 157 · see citing works
Rohling, M. L., Binder, L. M., & Langhinrichsen‐Rohling, J. (1995) · Health Psychology · doi:10.1037/0278-6133.14.6.537 · Cited by 155 · see citing works
Loisel, P., Gosselin, L., Durand, P. M., Lemaire, J., Poitras, S., & Abenhaim, L. (2001) · Applied Ergonomics · doi:10.1016/s0003-6870(00)00038-7 · Cited by 146 · see citing works
Schiøttz‐Christensen, B. (1999) · Family Practice · doi:10.1093/fampra/16.3.223 · Cited by 144 · see citing works
Biopsychosocial Determinants of Chronic Disability and Low-Back Pain: A Review
Truchon, M., & Fillion, L. (2000) · Journal of Occupational Rehabilitation · doi:10.1023/a:1009452019715 · Cited by 138 · see citing works
Pain‐related fear in low back pain: A prospective study in the general population
Leeuw, M., Houben, R. M. A., Severeijns, R., Picavet, H. S. J., Schouten, E. G. W., & Vlaeyen, J. W. S. (2006) · European Journal of Pain · doi:10.1016/j.ejpain.2006.02.009 · Cited by 133 · see citing works
Prognostic factors for chronic disability from acute low-back pain in occupational health care
van der Weide, W. E., Verbeek, J. H. A. M., Sallé, H. J. A., & van Dijk, F. J. H. (1999) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.383 · Cited by 131 · see citing works
Quantified Pain Drawing in Subacute Low Back Pain
Öhlund, C., Eek, C., Palmblad, S., Areskoug, B., & NACHEMSON, A. L. (1996) · Spine · doi:10.1097/00007632-199605010-00005 · Cited by 115 · see citing works
The importance of symptom duration in determining prognosis
Dunn, K. M., & Croft, P. R. (2006) · Pain · doi:10.1016/j.pain.2005.12.012 · Cited by 114 · see citing works
Self-citationDeterminants of disability after a work related musculetal injury.
Crook, J., Moldofsky, H., & Shannon, H. (1998) · PubMed · Cited by 107 · see citing works
Employment-Related Factors in Chronic Pain and Chronic Pain Disability
Teasell, R. W., & Bombardier, C. (2001) · Clinical Journal of Pain · doi:10.1097/00002508-200112001-00010 · Cited by 95 · see citing works
Harland, N. J., & Georgieff, K. (2003) · Rehabilitation Psychology · doi:10.1037/0090-5550.48.4.296 · Cited by 92 · see citing works
Coste, J., Lefrancois, G., Guillemin, F., Pouchot, J., & For the French Study Group for Quality of Life in Rheumatology (2004) · Arthritis Care & Research · doi:10.1002/art.20235 · Cited by 78 · see citing works
Steenstra, I. A., Koopman, F. S., Knol, D. L., Kat, E., Bongers, P. M., de Vet, H. C. W., & van Mechelen, W. (2005) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-005-8037-9 · Cited by 70 · see citing works
The impact of low back pain on work: A study in primary care consulters
Wynne‐Jones, G., Dunn, K. M., & Main, C. J. (2007) · European Journal of Pain · doi:10.1016/j.ejpain.2007.04.006 · Cited by 60 · see citing works
Self-citationPsychological Factors and the Development of Chronic Pain
Kuch, K. (2001) · Clinical Journal of Pain · doi:10.1097/00002508-200112001-00009 · Cited by 57 · see citing works
Teasell, R. W. (2001) · Clinical Journal of Pain · doi:10.1097/00002508-200112001-00011 · Cited by 49 · see citing works
Low Back Pain Prognosis: Structured Review of the Literature
McIntosh, G., Frank, J. W., Hogg‐Johnson, S., et al. (2000) · Journal of Occupational Rehabilitation · doi:10.1023/a:1009450102876 · Cited by 26 · see citing works
van Tulder, M. W. (2006) · European Spine Journal · Cited by 9 · see citing works
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Catastrophizing-a prognostic factor for outcome in patients with low back pain: a systematic review
Wertli, M. M., Eugster, R., Held, U., Steurer, J., Kofmehl, R., & Weiser, S. (2014) · The Spine Journal · doi:10.1016/j.spinee.2014.03.003 · Cited by 363 · see citing works
Chronic pain and sex-differences; women accept and move, while men feel blue
Rovner, G. S., Sunnerhagen, K. S., Björkdahl, A., Gerdle, B., Börsbo, B., Johansson, F., & Gillanders, D. (2017) · PLOS ONE · doi:10.1371/journal.pone.0175737 · Cited by 179 · see citing works
Marsden, J., White, M., Annand, F., Burkinshaw, P., Carville, S., Eastwood, B., Kelleher, M., Knight, J., O'Connor, R., Tran, A., et al. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30331-1 · Cited by 106 · see citing works
Brunner, E., De Herdt, A., Minguet, P., Baldew, S.-S., & Probst, M. (2013) · Disability and Rehabilitation · doi:10.3109/09638288.2012.683848 · Cited by 96 · see citing works
Field, J., & Newell, D. (2012) · Chiropractic & Manual Therapies · doi:10.1186/2045-709x-20-17 · Cited by 61 · see citing works
Optimizing prediction of back pain outcomes
Turner, J. A., Shortreed, S. M., Saunders, K. W., LeResche, L., Berlin, J. A., & Korff, M. V. (2013) · Pain · doi:10.1016/j.pain.2013.04.029 · Cited by 45 · see citing works
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George, E., Elman, I., Becerra, L., Berg, S., & Borsook, D. (2016) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2016.04.002 · Cited by 18 · see citing works
Montero-Cuadrado, F., Barrero-Santiago, L., Llamas-Ramos, R., & Llamas-Ramos, I. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010185 · Cited by 10 · see citing works
- Authors
- Grotle, M., Foster, N. E., Dunn, K. M., & Croft, P.
- Affiliations
- Oslo University Hospital (NO)
- Arthritis Research UK (GB)
- Corresponding author
- Grotle, Margreth
- Venue
- Pain
- Published
- 2010-12
- Volume
- 151
- Issue
- 3
- Pages
- 790-797
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC3398128
- OpenAlex
- W1991490088
- Cited by
- 196
- References
- 54
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 12 · 2023: 10 · 2022: 9 · 2021: 16 · 2020: 18 · 2019: 12 · 2018: 13 · 2017: 13 · 2016: 16 · 2015: 14 · 2014: 17 · 2013: 17 · 2012: 12
- FWCI
- 8.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Wellcome Trust (083572)
- Versus Arthritis
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- low back pain, chronic low back pain, acute low back pain, prognostic factors, disability, Roland-Morris Disability Questionnaire, fear of pain, pain catastrophizing, widespread pain, employment status, primary care, outcome prediction
- MeSH terms
- Acute Disease, Adolescent, Adult, Anxiety, Chronic Disease, Disability Evaluation, Fear, Female, Humans, Male, Middle Aged, Pain Measurement, Prognosis, Prospective Studies, Psychiatric Status Rating Scales, Surveys and Questionnaires, Regression Analysis, Treatment Outcome, Low Back Pain, Physicians, Primary Care, Catastrophization
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