title: Can patients identify what triggers their back pain? Secondary analysis of a case-crossover study.
abstract: The aim of this case-crossover study was to investigate the extent to which patients can accurately nominate what triggered their new episode of sudden-onset acute low back pain (LBP). We interviewed 999 primary care patients to record exposure to 12 standard triggers and also asked the patients to nominate what they believed triggered their LBP. Exposure to the patient-nominated trigger during the case window was compared with exposure in the control window. Conditional logistic regression models were constructed to quantify the risk of LBP onset associated with the patient-nominated trigger. Sensitivity analyses were conducted varying the duration and timing of case/control windows. We compared the extent to which patient-nominated triggers matched standard triggers. The odds ratios for exposure to patient-nominated triggers ranged from 8.60 to 30.00, suggesting that exposure increases the risk of LBP. Patients' understanding of triggers however seems incomplete, as we found evidence that while some of the standard triggers were well recognised (such as lifting heavy loads), others (such as being distracted during manual tasks) were under-recognised as possible triggers of an episode of LBP. This study provides some evidence that patients can accurately nominate the activity that triggered their new episode of sudden-onset acute LBP.
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia Federal University of Minas Gerais, Belo Horizonte, Brazil Sydney Medical School, The University of Sydney, Sydney, Australia Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, Sydney, Australia.
authors.forename: Patricia
authors.initials: P
authors.lastname: do Carmo Silva Parreira
authors.forename: Chris G
authors.initials: CG
authors.lastname: Maher
authors.forename: Jane
authors.initials: J
authors.lastname: Latimer
authors.forename: Daniel
authors.initials: D
authors.lastname: Steffens
authors.forename: Fiona
authors.initials: F
authors.lastname: Blyth
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Manuela L
authors.initials: ML
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D001416:Back Pain / Q000175:diagnosis* / Q000209:etiology*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D011320:Primary Health Care; D018570:Risk Assessment; D013997:Time Factors