Prognosis and quality of life in patients with acute low back pain: Insights from a comprehensive inception cohort study
Article first published online: 5 APR 2004
Copyright © 2004 by the American College of Rheumatology
Arthritis Care & Research
Volume 51, Issue 2, pages 168–176, 15 April 2004
How to Cite
Coste, J., Lefrançois, G., Guillemin, F., Pouchot, J. and For the French Study Group for Quality of Life in Rheumatology (2004), Prognosis and quality of life in patients with acute low back pain: Insights from a comprehensive inception cohort study. Arthritis & Rheumatism, 51: 168–176. doi: 10.1002/art.20235
- Issue published online: 5 APR 2004
- Article first published online: 5 APR 2004
- Manuscript Accepted: 26 MAY 2003
- Manuscript Received: 26 DEC 2002
- Chiesi Company
- Low back pain;
- Health-related quality of life;
- Psychosocial factors
To investigate the respective contribution of various biologic and psychosocial factors, especially initial health-related quality of life (HRQOL), in the natural history of acute low back pain (LBP) and to evaluate the impact of this condition on HRQOL.
For 3 months, we assessed 113 patients consulting for nonspecific acute LBP of <72 hours duration at inclusion and treated with acetaminophen. Endpoints included pain, disability assessed by the Roland Disability Questionnaire, and HRQOL assessed by the Short Form 36 health survey (SF-36).
Seventy-three percent of patients recovered within 2 weeks and 5% of patients developed chronic LBP. Prior low back surgery, higher initial disability questionnaire score, lower SF-36 score, and temporary compensation status were independently associated with delayed recovery. The impact of the acute LBP episode on HRQOL was brief and moderate, except for patients with comorbidity, psychiatric disorders, those of foreign origin, unemployed, or with job dissatisfaction. The impact of compensation status, sick leave, and bed rest was more profound and lasting.
This study highlights the large contribution of work-related factors, but also initial HRQOL, to the prognosis of LBP. It also suggests that LBP impairs HRQOL mainly through compensation and inappropriate medical care, and that, in turn, impaired HRQOL favors the condition becoming chronic. These findings have implications for future research into the management of LBP.