title: Does anterior trunk pain predict a different course of recovery in chronic low back pain?
abstract: Patient characteristics associated with the course and severity of low back pain (LBP) and disability have been the focus of extensive research, however, known characteristics do not explain much of the variance in outcomes. The relationship between anterior trunk pain (ATP) and LBP has not been explored, though mechanisms for visceral referred pain have been described. Study objectives were: (1) determine prevalence of ATP in chronic LBP patients, (2) determine whether ATP is associated with increased pain and disability in these patients, and (3) evaluate whether ATP predicts the course of pain and disability in these patients. In this study, spinal outpatient department patients mapped the distribution of their pain and patients describing pain in their chest, abdomen or groin were classified with ATP. Generalized estimating equations were performed to investigate the relationship between ATP and LBP outcomes. A total of 2974 patients were included and 19.6% of patients reported ATP. At all time points, there were significant differences in absolute pain intensity and disability in those with ATP compared with those without. The presence of ATP did not affect the clinical course of LBP outcomes. The results of this study suggest that patients who present with LBP and ATP have higher pain and disability levels than patients with localised LBP. Visceral referred pain mechanisms may help to explain some of this difference.
authors: Faculty of Human Sciences, Macquarie University, Sydney, NSW, Australia Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
authors: John
authors: J
authors: Panagopoulos
authors: Mark J
authors: MJ
authors: Hancock
authors: Alice
authors: A
authors: Kongsted
authors: Julia
authors: J
authors: Hush
authors: Peter
authors: P
authors: Kent
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053591:Referred Pain / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Anterior trunk pain; Disability; Low back pain; Prognostic factors; Visceral pain