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Factors leading to chronic back pain

Factors leading to chronic back pain

“Recent evidence has questioned the prevailing belief that acute LBP resolves within 3 months. A systematic review indicated that 2% to 48% (median, 26%) of patients with acute LBP in primary care settings transition to chronic LBP.”

Care that is not in keeping with current clinical guidelines (nonconcordant) care can lead to direct and indirect harm to the back pain sufferer, given that it has been linked with medicalization and unnecessary health care utilization.

To help health care professionals better care for their patients this paper looked at which risk factors increase the odds of acute lower back pain becoming chronic.

Examples of nonconcordant care provided by the authors: Prescription of opioids, prescription of antidepressant without diagnosis of depression, and the prescription of systemic corticosteroids, benzodiapezines or acetaminophen.

The authors found

“Patient and clinical characteristics associated with transition to chronic LBP included obesity, smoking, severe and very severe baseline disability and diagnosed depression/anxiety. After controlling for all other variables, patients exposed to 1, 2, or 3 nonconcordant processes of care within the first 21 days were 1.39 and 2.16 times more likely to develop chronic LBP compared with those with no exposure (P < .001).”

Dr Notley follows the recommended guidelines of “reassurance and advice to maintain activity as tolerated.” Along with “the use of acupuncture, and spinal manipulation which are “first-line treatment options” for those with lower back pain.

Reference

doi:10.1001/jamanetworkopen.2020.37371

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