title: Prognosis and course of pain in patients with chronic non-specific low back pain: A 1-year follow-up cohort study.
abstract: BACKGROUND
  It remains unclear to what extent patients recover from chronic non-specific low back pain (NSLBP). The objective of this study was to determine (1) the course of chronic NSLBP in tertiary care and (2) which factors predicted 5- and 12-month outcomes.
  
  
  METHODS
  This prospective study includes 1760 chronic NSLBP patients from a rehabilitation clinic (mean age 40.1 years, SD 10.6). After baseline measurement, patients followed a 2-month multidisciplinary therapy programme; evaluation took place at 2, 5 and 12 months post baseline. Recovery was defined as (1) relative recovery [30% improvement on the pain, visual analogue scale (VAS) compared with baseline] and (2) absolute recovery (VAS pain ≤ 10 mm). The multivariate logistic regression analysis included 23 baseline characteristics.
  
  
  RESULTS
  Patient-reported intensity of back pain decreased from 55.5 (SD 23.0) at baseline to 37.0 (SD 23.8), 35.3 (SD 26.1) and 32.3 (SD 26.9) at 2-, 5- and 12-month follow-up, respectively. Younger age, back pain at baseline, no psychological/physical dysfunction (Symptom Check List-90, item 9), and higher baseline scores on the physical component scale and mental component scale of quality of life (Short Form-36) were positively associated with recovery at 5 and 12 months. At 5-month follow-up, higher work participation at baseline was also a prognostic factor for both definitions of recovery. At 12-month follow-up, having co-morbidity was predictive for both definitions.
  
  
  CONCLUSIONS
  The results of this study indicate that in chronic NSLBP patients, bio-psychosocial prognostic factors may be important for clinicians when predicting recovery in back pain intensity during a 1-year period.
authors.affiliation: Rotterdam University of Applied Sciences, The Netherlands.|Spine & Joint Centre, Rotterdam, The Netherlands.|Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Verkerk
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: P A J
authors.initials: PA
authors.lastname: Luijsterburg
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.|Department of Methodology and Applied Biostatistics, Institute for Health Sciences, VU University, Amsterdam, The Netherlands.|Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: M W
authors.initials: MW
authors.lastname: Heymans
authors.affiliation: Spine & Joint Centre, Rotterdam, The Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Ronchetti
authors.affiliation: Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: A L
authors.initials: AL
authors.lastname: Pool-Goudzwaard
authors.affiliation: Rotterdam University of Applied Sciences, The Netherlands.
authors.forename: H S
authors.initials: HS
authors.lastname: Miedema
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: B W
authors.initials: BW
authors.lastname: Koes
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D063128:Tertiary Health Care; D016896:Treatment Outcome