Cited by 702Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyMedical Practices and Rehabilitation

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Psychosocial Predictors of Outcome in Acute and Subchronic Low Back Trouble

Burton, A. Kim, Tillotson, K. Malcolm, Main, Chris J., Hollis, Sally·1995·Spine

DOI 10.1097/00007632-199503150-00014

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Abstract

STUDY DESIGN: A prospective survey of patients seeking primary care for low back pain. Clinical and psychosocial data, available at presentation, were explored for predictors of outcome at 1 year. OBJECTIVES: To determine the relative value of clinical and psychosocial variables for early identification of patients with a poor prognosis. SUMMARY OF BACKGROUND DATA: Current treatment strategies for low back pain have failed to stem the rising levels of disability. Psychosocial factors have been shown to be important determinants of response to therapy in chronic patients, but the contribution from similar data in acute or subchronic patients has not been comprehensively investigated. METHODS: Two hundred fifty-two patients with low back pain, presenting to primary care, underwent a structured clinical interview and completed a battery of psychosocial instruments. Follow-up was done by mail at 1 year; outcome was measured using a back pain disability questionnaire. Predictive relationships were sought between the data at presentation and disability at follow-up. RESULTS: Most patients showed improved disability and pain scores, although more than half had persisting symptoms. Eighteen percent showed significant psychological distress at presentation. Multiple regression analysis showed the level of persisting disability to depend principally on measures in the psychosocial domain; for acute cases outcome is also dependent on the absence or presence of a previous history of low back trouble. Discriminant models successfully allocated typically 76% of cases to recovered/not-recovered groups, largely on the basis of psychosocial factors evident at presentation. CONCLUSIONS: Early identification of psychosocial problems is important in understanding, and hopefully preventing, the progression to chronicity in low back trouble.

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Highly Cited Works in Spinal Disorders
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“A large body of research indicates that these variables are involved in the transition from acute to chronic disability among patients with back pain problems [25, 38–43].”
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“Catastrophizing was more than 7 times more powerful a predictor than any other predictor or clinical variable among acute back pain patients in determining the risk of subsequent chronic pain [ 11 ].”
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Alexithymia and Somatization in Chronic Pain Patients: A Sequential Mediation Model
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“Nevertheless, their effect size varied substantially, ranging from d = 0.2 (Dionne et al., 1995) to d = 0.6 at 1-year follow-up (Burton et al., 1995), and d = 0.9 at 2-year follow-up (Dionne et al., 1997).”
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Is ergonomic intervention alone sufficient to limit musculoskeletal problems in nurses?
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Self-citation
Preventing Progression to Chronicity in First Onset, Subacute Low Back Pain: An Exploratory Study
Slater, M. A., Weickgenant, A. L., Greenberg, M. A., Wahlgren, D. R., Williams, R. A., Carter, C., Patterson, T. L., Grant, I., Garfin, S. R., Webster, J. S., et al. (2009) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2008.10.032 · Cited by 40
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Authors: Burton, A. K., Tillotson, K. M., Main, C. J., & Hollis, S.
Affiliations: University of Huddersfield (GB)
Salford Royal NHS Foundation Trust (GB)
Corresponding author: Tillotson, K. Malcolm
ORCID: Main, Chris J.
Venue: Spine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1995-03
Volume: 20
Issue: 6
Pages: 722-728
ISSN: 0362-2436 (ISSN-L)
DOI: 10.1097/00007632-199503150-00014
OpenAlex: W1970664734
Cited by: 700
References: 0
Citations by year: 2026: 4 · 2025: 2 · 2024: 11 · 2023: 9 · 2022: 9 · 2021: 18 · 2020: 13 · 2019: 14 · 2018: 19 · 2017: 13 · 2016: 19 · 2015: 15 · 2014: 22 · 2013: 22 · 2012: 29
FWCI: 15.04
Type: journal article
Language: en
Open access: closed
Locations: Spine (publishedVersion)
PubMed (publishedVersion)
University of Huddersfield Repository (University of Huddersfield) (submittedVersion)
Lancaster EPrints (Lancaster University) (submittedVersion)
Research Explorer (The University of Manchester) (submittedVersion)
Huddersfield Research Portal (University of Huddersfield) (submittedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords: low back pain, psychosocial factors, prognosis, disability, psychological distress, acute low back pain, outcome prediction, primary care
MeSH terms: Acute Disease, Adult, Chronic Disease, Disability Evaluation, Female, Follow-Up Studies, Humans, Male, Pain Measurement, Prospective Studies, Discriminant Analysis, Low Back Pain

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Psychosocial Predictors of Outcome in Acute and Subchronic Low Back Trouble

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