Does a healthy lifestyle behaviour influence the prognosis of low back pain among men and women in a general population? A population-based cohort study

Abstract Background Over one year, the majority of patients with low back pain (LBP) from the secondary care sector could not report a single week without LBP and few could report a non-episode, defined as at least one month without LBP. Presumably, non-episodes would be more common in the general population. The aim of this study was to assess the usefulness of this definition of ´”non-episodes”, by studying their presence over one year in the general population. Specifically, we wanted to: 1) determine the prevalence of non-episodes, 2) identify the proportion of study participants who could be classified as being in a non-episode at the end of the observation period, and 3) estimate the proportion of participants classified as having at least two separate non-episodes. Methods Danes, aged 49/50, who previously participated in a population-based study on LBP received fortnightly automated text (SMS) messages over one year. Each time, participants reported the number of days with LBP in the preceding fortnight. Fortnights with 0 days of LBP were defined as ‘zero-fortnights’ and two such fortnights in a row (one month) were defined as a ‘non-episode’. Estimates are reported as percentages with their 95% confidence intervals in brackets. Results Two hundred and ninety-three people were invited to participate. Of these, 16 declined participation and 16 were excluded because they failed to return their text message at least 20 of the 26 times, leaving 261 in the current analyses. Of these, 11% (2-22) never reported a zero-fortnight. In all, 83% (78-88) had at least one non-episode throughout the study period and the proportion of participants classified as being in a non-episode at the end of the study was 59% (53-65). The percentage of individuals with at least two non-episodes was 52% (46-58). Conclusions It is possible to differentiate people from the general population as having or not having episodes of LBP using the definition of absence of LBP over one month as the measure. Non-episodes were far more common in the general population than in the secondary care sector, suggesting it to be a potentially useful definition in research.

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Are job strain and sleep disturbances prognostic factors for low-back pain? A cohort study of a general population of working age in Sweden

Journal of Rehabilitation Medicine ◽

10.2340/16501977-2249 ◽

2017 ◽

Vol 49 (7) ◽

pp. 591-597 ◽

Cited By ~ 6

Author(s):

E Rasmussen-Barr ◽

W Grooten ◽

J Hallqvist ◽

L Holm ◽

E Skillgate

Keyword(s):

Cohort Study ◽

Low Back Pain ◽

Prognostic Factors ◽

Back Pain ◽

General Population ◽

Sleep Disturbances ◽

Job Strain ◽

Low Back ◽

Working Age

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Increased risk of strokes in patients with chronic low back pain (CLBP): A nationwide population-based cohort study

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2020.105725 ◽

2020 ◽

Vol 192 ◽

pp. 105725

Author(s):

Hao-Chin Wang ◽

Yuan-Chih Su ◽

Hsiang-Ning Luk ◽

Jen-Hung Wang ◽

Chung-Y Hsu ◽

...

Keyword(s):

Cohort Study ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Population Based ◽

Low Back ◽

Increased Risk

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Examining the effects of low back pain and mental health symptoms on healthcare utilisation and costs: a protocol for a population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2019-031749 ◽

2019 ◽

Vol 9 (9) ◽

pp. e031749 ◽

Cited By ~ 1

Author(s):

Jessica J Wong ◽

Pierre Côté ◽

Andrea C Tricco ◽

Laura C Rosella

Keyword(s):

Mental Health ◽

Cohort Study ◽

Low Back Pain ◽

Back Pain ◽

Healthcare Utilisation ◽

Population Based ◽

Community Dwelling ◽

Low Back ◽

Mental Health Symptoms ◽

Health Symptoms

IntroductionLow back pain (LBP) is a leading cause of disability associated with high healthcare utilisation and costs. Mental health symptoms are negative prognostic factors for LBP recovery; however, no population-based studies have assessed the joint effects of LBP and mental health symptoms on healthcare utilisation. This proposed study will characterise the health system burden of LBP and help identify priority groups to inform resource allocation and public health strategies. Among community-dwelling adult respondents of five cycles of the Canadian Community Health Survey (CCHS) in Ontario, we aim to assess the effect of self-reported LBP on healthcare utilisation and costs and assess whether this effect differs between those with and without self-reported mental health symptoms.Methods and analysisWe designed a dynamic population-based cohort study using linkages of survey and administrative data housed at ICES. The Ontario sample of CCHS (2003–2004, 2005–2006, 2007/2008, 2009/2010, 2011/2012; total of ~1 30 000 eligible respondents) will be used to define the cohort of adults with self-reported LBP with and without mental health symptoms. Healthcare utilisation and costs will be assessed by linking health administrative databases. Follow-up ranges from 6 to 15 years (until 31 March 2018). Sociodemographic (eg, age, sex, education) and health behaviour (eg, comorbidities, physical activity) factors will be considered as potential confounders. Poisson and linear (log-transformed) regression models will be used to assess the association between LBP and healthcare utilisation and costs. We will assess effect modification with mental health symptoms on the additive and multiplicative scales and conduct sensitivity analyses to assess the impact of misclassification and residual confounding.Ethics and disseminationThis study is approved by the University of Toronto Research Ethics Board. We will disseminate findings using a multifaceted knowledge translation strategy, including scientific conference presentations, publications in peer-reviewed journals and workshops with key knowledge users.

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