Skip to main content
Top
Published in: European Spine Journal 7/2007

01-07-2007 | Original Article

Spinal mechanical load: a predictor of persistent low back pain? A prospective cohort study

Authors: Eric W. P. Bakker, Arianne P. Verhagen, Cees Lucas, Hans J. C. M. F. Koning, Bart W. Koes

Published in: European Spine Journal | Issue 7/2007

Login to get access

Abstract

Prospective inception cohort. To assess the prognostic value of spinal mechanical load, assessed with the 24-hour schedule (24HS), in subjects with acute non-specific low back pain (ALBP) and to examine the influence of spinal mechanical load on the course of ALBP. In view of the characteristics of the natural course of ALBP, this should be viewed as a persistent condition in many patients rather that a benign self-limiting disease. Therefore, secondary prevention could be beneficial. Spinal mechanical load is a risk factor for ALBP and possibly a (modifiable) prognostic factor for persistent (i.e. recurrent and/or chronic) LBP. One hundred patients from primary care with ALBP were eligible for inclusion. At 6 months, 88 subjects completed the follow-up. For the follow-up assessment a research assistant, unaware of our interest in the prognostic factors, contacted the subjects by telephone. Questionnaires were completed focusing on changes in demographic data and on the course and current status of ALBP. Persistent LBP occurred in 60% subjects. After multivariate regression analysis smoking (harmful) and advanced age (protective) were associated with persistent LBP. Differences in 24HS scores at baseline and follow-up were univariate-related to persistent LBP. Spinal mechanical load, quantified with the 24HS, is not a prognostic factor for persistent LBP. Modification of spinal mechanical load in terms of 24HS scores could be beneficial for secondary prevention in patients with acute LBP.
Literature
1.
go back to reference Altman DG (1980) Statistics and ethics in medical research: III. How large a sample. Br Med J 281:1336–1338 Altman DG (1980) Statistics and ethics in medical research: III. How large a sample. Br Med J 281:1336–1338
2.
go back to reference Altman DG (1997) Relation between several variables. In: Altman DG (ed) Practical statistics for medical research. Chapman & Hall/CRC, Boca Raton pp 325–361 Altman DG (1997) Relation between several variables. In: Altman DG (ed) Practical statistics for medical research. Chapman & Hall/CRC, Boca Raton pp 325–361
3.
go back to reference Bakker EWP, Koning JCMF, Verhagen AP, Koes BW (2003) Interobserver reliability of the 24-hour schedule in patients with low back pain. JMPT 26(4):226–232PubMed Bakker EWP, Koning JCMF, Verhagen AP, Koes BW (2003) Interobserver reliability of the 24-hour schedule in patients with low back pain. JMPT 26(4):226–232PubMed
4.
go back to reference Bakker EWP, Verhagen AP, Lucas C, Koning JCMF, Haan de RJ, Koes BW (2006) Daily spinal mechanical loading as a risk factor for acute non-specific low back pain. Eur Spine J (epub ahead of print) Bakker EWP, Verhagen AP, Lucas C, Koning JCMF, Haan de RJ, Koes BW (2006) Daily spinal mechanical loading as a risk factor for acute non-specific low back pain. Eur Spine J (epub ahead of print)
5.
go back to reference Chavannes AW, Mens JMA, Koes BW, Lubbers WJ, Ostelo R, Spinnewijn WEM, Kolnaar BGM (2005) NHG-standaard lage rugpijn. Huisarts Wet 48(3):113–123 Chavannes AW, Mens JMA, Koes BW, Lubbers WJ, Ostelo R, Spinnewijn WEM, Kolnaar BGM (2005) NHG-standaard lage rugpijn. Huisarts Wet 48(3):113–123
6.
go back to reference Croft PR, Macfarlane GJ, Papageorgiou AC, Thomas E, Silman AJ (1998) Outcome of low back pain in general practice: a prospective study. BMJ 316(7141):1356–1359PubMed Croft PR, Macfarlane GJ, Papageorgiou AC, Thomas E, Silman AJ (1998) Outcome of low back pain in general practice: a prospective study. BMJ 316(7141):1356–1359PubMed
7.
go back to reference Dionne CE, Koepsell TD, Von Korff M, Deyo RA, Barlow WE, Checkoway H (1997) Predicting long-term functional limitations among back pain patients in primary care settings. J Clin Epidemiol 50(1):31–43PubMedCrossRef Dionne CE, Koepsell TD, Von Korff M, Deyo RA, Barlow WE, Checkoway H (1997) Predicting long-term functional limitations among back pain patients in primary care settings. J Clin Epidemiol 50(1):31–43PubMedCrossRef
8.
go back to reference Dunn KM, Croft PR (2004) Epidemiology and natural history of low back pain. Eura Medicophys 40(1):9–13PubMed Dunn KM, Croft PR (2004) Epidemiology and natural history of low back pain. Eura Medicophys 40(1):9–13PubMed
9.
go back to reference Erdman RA, Passchier J, Kooijman M, Stronks DL (1993) The Dutch version of the Nottingham Health Profile: investigations of psychometric aspects. Psychol Rep 72(3 Pt 1):1027–1035PubMed Erdman RA, Passchier J, Kooijman M, Stronks DL (1993) The Dutch version of the Nottingham Health Profile: investigations of psychometric aspects. Psychol Rep 72(3 Pt 1):1027–1035PubMed
10.
go back to reference Faas A, Chavannes AW, Koes BW, Hoogen JMM van den, Mens JMA, Smeele LJM (1996) NHG-standaard lage rugpijn. Huisarts Wet 39:18–31 Faas A, Chavannes AW, Koes BW, Hoogen JMM van den, Mens JMA, Smeele LJM (1996) NHG-standaard lage rugpijn. Huisarts Wet 39:18–31
12.
go back to reference Hoogen van den HJ, Koes BW, Deville W, van Eijk JT, Bouter LM (1997) The prognosis of low back pain in general practice. Spine 1 22(13):1515–1521CrossRef Hoogen van den HJ, Koes BW, Deville W, van Eijk JT, Bouter LM (1997) The prognosis of low back pain in general practice. Spine 1 22(13):1515–1521CrossRef
13.
go back to reference Jeaschke R, Singer J, Guyatt GH (1990) A comparison of seven-point and visual analogue scales. Control Clin Trials 11:43–51CrossRef Jeaschke R, Singer J, Guyatt GH (1990) A comparison of seven-point and visual analogue scales. Control Clin Trials 11:43–51CrossRef
14.
go back to reference Koes BW, van Tulder MW, Ostelo R, Kim Burton A, Waddell G (2001) Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine 26(22):2504–2513PubMedCrossRef Koes BW, van Tulder MW, Ostelo R, Kim Burton A, Waddell G (2001) Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine 26(22):2504–2513PubMedCrossRef
15.
16.
go back to reference Nachemson A (1975) Towards a better understanding of low-back pain: a review of the mechanics of the lumbar disc. Rheumatol Rehabil 14(3):129–143PubMedCrossRef Nachemson A (1975) Towards a better understanding of low-back pain: a review of the mechanics of the lumbar disc. Rheumatol Rehabil 14(3):129–143PubMedCrossRef
17.
go back to reference OPCS (1994) Office of Population Censuses and Surveys. Monitor MB5 94/1 Morbidity Statistics from General Practice 1991/2 (MSGP4). HMSO, London OPCS (1994) Office of Population Censuses and Surveys. Monitor MB5 94/1 Morbidity Statistics from General Practice 1991/2 (MSGP4). HMSO, London
18.
go back to reference Papageorgiou AC, Macfarlane GJ, Thomas E, Croft PR, Jayson MIV, Silman AJ (1997) Psychosocial factors in the work place—do they predict new episodes of low back pain? Spine 22:1137–1142PubMedCrossRef Papageorgiou AC, Macfarlane GJ, Thomas E, Croft PR, Jayson MIV, Silman AJ (1997) Psychosocial factors in the work place—do they predict new episodes of low back pain? Spine 22:1137–1142PubMedCrossRef
19.
go back to reference Pengel LHM, Herbert RD, Maher CG, Refshauge KM (2003) Acute low back pain: systematic review of its prognosis. BMJ 327(7410):323PubMedCrossRef Pengel LHM, Herbert RD, Maher CG, Refshauge KM (2003) Acute low back pain: systematic review of its prognosis. BMJ 327(7410):323PubMedCrossRef
20.
go back to reference Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine 27:E109–E120PubMedCrossRef Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine 27:E109–E120PubMedCrossRef
21.
go back to reference Reis S, Hermoni D, Borkan JM, Biderman A, Tabenkin C, Porat A (1999) A new look at low back complaints in primary care: a RAMBAM Israeli Family Practice Research Network study. J Fam Pract 48:299–303PubMed Reis S, Hermoni D, Borkan JM, Biderman A, Tabenkin C, Porat A (1999) A new look at low back complaints in primary care: a RAMBAM Israeli Family Practice Research Network study. J Fam Pract 48:299–303PubMed
22.
go back to reference Rossignol M, Suissa S, Abenhaim L (1988) Working disability due to occupational back pain: three years follow-up of 2300 compensated workers in Quebec. J Occup Med 30:502–505PubMedCrossRef Rossignol M, Suissa S, Abenhaim L (1988) Working disability due to occupational back pain: three years follow-up of 2300 compensated workers in Quebec. J Occup Med 30:502–505PubMedCrossRef
23.
go back to reference Sackett DL, Haynes RB, Guyatt GH, Tugwell P (1991) Clinical epidemiology, a basic science for clinical medicine. Little, Brown, Boston Sackett DL, Haynes RB, Guyatt GH, Tugwell P (1991) Clinical epidemiology, a basic science for clinical medicine. Little, Brown, Boston
24.
go back to reference Sato K, Kikuchi S, Yonezawa T (1999) In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems. Spine 24(23):2468–2474PubMedCrossRef Sato K, Kikuchi S, Yonezawa T (1999) In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems. Spine 24(23):2468–2474PubMedCrossRef
25.
go back to reference Seferlis T, Nemeth G, Carlsson AM (2000) Prediction of functional disability, recurrences, and chronicity after 1 year in 180 patients who required sick leave for acute low-back pain. J Spinal Disord 13:470–477PubMedCrossRef Seferlis T, Nemeth G, Carlsson AM (2000) Prediction of functional disability, recurrences, and chronicity after 1 year in 180 patients who required sick leave for acute low-back pain. J Spinal Disord 13:470–477PubMedCrossRef
26.
go back to reference Schiottz-Christensen B, Nielsen GL, Hansen VK, Schodt T, Sorensen HT, Olesen F (1999) Long-term prognosis of acute low back pain in patients seen in general practice: a 1-year prospective follow-up study. Fam Pract 16:223–232PubMedCrossRef Schiottz-Christensen B, Nielsen GL, Hansen VK, Schodt T, Sorensen HT, Olesen F (1999) Long-term prognosis of acute low back pain in patients seen in general practice: a 1-year prospective follow-up study. Fam Pract 16:223–232PubMedCrossRef
27.
go back to reference Thomas E, Silman AJ, Croft PR, Papageorgiou AC, Jayson MI, Macfarlane GJ (1999) Predicting who develops chronic low back pain in primary care: a prospective study. BMJ 19 318(7199):1662–1667 Thomas E, Silman AJ, Croft PR, Papageorgiou AC, Jayson MI, Macfarlane GJ (1999) Predicting who develops chronic low back pain in primary care: a prospective study. BMJ 19 318(7199):1662–1667
28.
go back to reference Vlaeyen JWS, Heuts PHTG (2000) Gedragsgeoriënteerde behandeling bij lage rugpijn. Bohn Stafleu Van Loghum, Houten/Diegem Vlaeyen JWS, Heuts PHTG (2000) Gedragsgeoriënteerde behandeling bij lage rugpijn. Bohn Stafleu Van Loghum, Houten/Diegem
29.
30.
go back to reference Waddell G (2004) The back pain revolution, 2nd edn. Churchill Livingstone, London Waddell G (2004) The back pain revolution, 2nd edn. Churchill Livingstone, London
31.
go back to reference Walker BF (2000) The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord 13(3):205–217PubMedCrossRef Walker BF (2000) The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord 13(3):205–217PubMedCrossRef
Metadata
Title
Spinal mechanical load: a predictor of persistent low back pain? A prospective cohort study
Authors
Eric W. P. Bakker
Arianne P. Verhagen
Cees Lucas
Hans J. C. M. F. Koning
Bart W. Koes
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 7/2007
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-007-0347-5

Other articles of this Issue 7/2007

European Spine Journal 7/2007 Go to the issue