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Identification of prognostic factors for chronicity in patients with low back pain: a review of screening instruments

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Abstract

Low back pain (LBP) is currently the most prevalent and costly musculoskeletal problem in modern societies. Screening instruments for the identification of prognostic factors in LBP may help to identify patients with an unfavourable outcome. In this systematic review screening instruments published between 1970 and 2007 were identified by a literature search. Nine different instruments were analysed and their different items grouped into ten structures. Finally, the predictive effectiveness of these structures was examined for the dependent variables including “work status“, “functional limitation”, and “pain“. The strongest predictors for “work status” were psychosocial and occupational structures, whereas for “functional limitation” and “pain” psychological structures were dominating. Psychological and occupational factors show a high reliability for the prognosis of patients with LBP. Screening instruments for the identification of prognostic factors in patients with LBP should include these factors as a minimum core set.

Résumé

La lombalgie (LBP) est un problème important notamment sur le poste des dépenses dans nos sociétés modernes. Sur le plan évolutif, il est primordial de pouvoir dépister des facteurs pronostics négatifs de ces patients. entre 1970 et 2007, un certain nombre d’éléments permettant cette analyse ont été identifiés dans la littérature. Ces instruments d’analyse nous semblent importants de façon à déterminer la limitation fonctionnelle, les possibilités de travail et la douleur. l’élément de prévision le plus important pour la poursuite d’un emploi est psychosocial, de ce fait l’élément important pour apprécier le pronostic de limitation fonctionnelle ou de douleur est plutôt psychologique. les facteurs psychologiques et sociaux permettent de faire le pronostic des lombalgies, il s’agit d’un tronc commun des éléments de dépistage, devant inclure tous ces facteurs.

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References

  1. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15(Suppl 2):S192–S300

    Article  PubMed  Google Scholar 

  2. Gobel H (2001) Epidemiology and costs of chronic pain syndromes exemplified by specific and unspecific low back pain. Schmerz 15:92–98

    Article  PubMed  CAS  Google Scholar 

  3. Grotle M, Vollestad NK, Brox JI (2006) Screening for yellow flags in first-time acute low back pain: reliability and validity of a Norwegian version of the Acute Low Back Pain Screening Questionnaire. Clin J Pain 22:458–467. doi:10.1097/01.ajp.0000208243.33498.cb

    Article  PubMed  Google Scholar 

  4. Hazard RG, Haugh LD, Reid S, Preble JB, MacDonald L (1996) Early prediction of chronic disability after occupational low back injury. Spine 21:945–951

    Article  PubMed  CAS  Google Scholar 

  5. Heneweer H, Aufdemkampe G, van Tulder MW, Kiers H, Stappaerts KH, Vanhees L (2007) Psychosocial variables in patients with (sub)acute low back pain: an inception cohort in primary care physical therapy in The Netherlands. Spine 32:586–592. doi:10.1097/01.brs.0000256447.72623.56

    Article  PubMed  Google Scholar 

  6. Hurley DA, Dusoir TE, McDonough SM, Moore AP, Baxter GD (2001) How effective is the acute low back pain screening questionnaire for predicting 1-year follow-up in patients with low back pain? Clin J Pain 17:256–263

    Article  PubMed  CAS  Google Scholar 

  7. Huyse FJ, Lyons JS, Stiefel FC, Slaets JP, de Jonge P, Fink P, Gans RO, Guex P, Herzog T, Lobo A, Smith GC, van Schijndel RS (1999) “INTERMED”: a method to assess health service needs. I. Development and reliability. Gen Hosp Psychiatry 21(1):39-48

  8. Ibrahim T, Tleyjeh IM, Gabbar O (2008) Surgical versus non-surgical treatment of chronic low back pain: a meta-analysis of randomised trials. Int Orthop 32:107–113. doi:10.1007/s00264-006-0269-6

    Article  PubMed  CAS  Google Scholar 

  9. Jensen MP, Turner JA, Romano JM, Strom SE (1995) The Chronic Pain Coping Inventory: development and preliminary validation. Pain 60(2):203–216

    Google Scholar 

  10. Katz JN (2006) Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am 88(Suppl 2):21–24

    Article  PubMed  Google Scholar 

  11. Linton SJ, Boersma K (2003) Early identification of patients at risk of developing a persistent back problem: the predictive validity of the Orebro Musculoskeletal Pain Questionnaire. Clin J Pain 19:80–86

    Article  PubMed  Google Scholar 

  12. Linton SJ, Hallden K (1998) Can we screen for problematic back pain? A screening questionnaire for predicting outcome in acute and subacute back pain. Clin J Pain 14:209–215

    Article  PubMed  CAS  Google Scholar 

  13. Melloh M, Aebli N, Elfering A, Roder C, Zweig T, Barz T, Herbison P, Hendrick P, Bajracharya S, Stout K, Theis JC (2008) Development of a screening tool predicting the transition from acute to chronic low back pain for patients in a GP setting: protocol of a multinational prospective cohort study [ACTRN12608000520336]. BMC Musculoskelet Disord (under review)

  14. Melloh M, Roder C, Elfering A, Theis JC, Muller U, Staub LP, Aghayev E, Zweig T, Barz T, Kohlmann T, Wieser S, Juni P, Zwahlen M (2008) Differences across health care systems in outcome and cost-utility of surgical and conservative treatment of chronic low back pain: a study protocol. BMC Musculoskelet Disord 9:81. doi:10.1186/1471-2474-9-81

    Article  PubMed  Google Scholar 

  15. Neubauer E, Junge A, Pirron P, Seemann H, Schiltenwolf M (2006) HKF-R 10 - screening for predicting chronicity in acute low back pain (LBP): a prospective clinical trial. Eur J Pain 10:559–566. doi:10.1016/j.ejpain.2005.08.002

    Article  PubMed  Google Scholar 

  16. Pfingsten M (2004) Fear avoidance beliefs in patients with back pain. Psychometric properties of the German version of the FABQ. Schmerz 18:17–27

    Article  PubMed  CAS  Google Scholar 

  17. Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine 27:E109–E120

    Article  PubMed  Google Scholar 

  18. Reis S, Borkan J, Vanraalte R, Tamir A, Dahan R, Hermoni D (2007) The LBP patient perception scale: a new predictor of LBP episode outcomes among primary care patients. Patient Educ Couns 67:191–195. doi:10.1016/j.pec.2007.03.015

    Article  PubMed  Google Scholar 

  19. Scerri M, de Goumoens P, Fritsch C, Van Melle G, Stiefel F, So A (2006) The INTERMED questionnaire for predicting return to work after a multidisciplinary rehabilitation program for chronic low back pain. Joint Bone Spine 73:736–741. doi:10.1016/j.jbspin.2005.12.012

    Article  PubMed  Google Scholar 

  20. Schmidt CO, Kohlmann T (2005) What do we know about the symptoms of back pain? Epidemiological results on prevalence, incidence, progression and risk factors. Z Orthop Ihre Grenzgeb 143:292–298

    Article  PubMed  CAS  Google Scholar 

  21. Schultz IZ, Crook J, Berkowitz J, Milner R, Meloche GR (2005) Predicting return to work after low back injury using the Psychosocial Risk for Occupational Disability Instrument: a validation study. J Occup Rehabil 15:365–376

    Article  PubMed  CAS  Google Scholar 

  22. Shaw WS, Pransky G, Fitzgerald TE (2001) Early prognosis for low back disability: intervention strategies for health care providers. Disabil Rehabil 23:815–828

    Article  PubMed  CAS  Google Scholar 

  23. Staerkle R, Mannion AF, Elfering A, Junge A, Semmer NK, Jacobshagen N, Grob D, Dvorak J, Boos N (2004) Longitudinal validation of the fear-avoidance beliefs questionnaire (FABQ) in a Swiss-German sample of low back pain patients. Eur Spine J 13:332–340

    Article  PubMed  Google Scholar 

  24. Steenstra IA, Verbeek JH, Heymans MW, Bongers PM (2005) Prognostic factors for duration of sick leave in patients sick listed with acute low back pain: a systematic review of the literature. Occup Environ Med 62:851–860

    Article  PubMed  CAS  Google Scholar 

  25. Stiefel FC, de Jonge P, Huyse FJ, Slaets JP, Guex P, Lyons JS, Vannotti M, Fritsch C, Moeri R, Leyvraz PF, So A, Spagnoli J (1999) INTERMED-an assessment and classification system for case complexity. Results in patients with low back pain. Spine 24:378–384, discussion 385

    Article  PubMed  CAS  Google Scholar 

  26. Truchon M, Cote D (2005) Predictive validity of the Chronic Pain Coping Inventory in subacute low back pain. Pain 116:205–212. doi:10.1016/j.pain.2005.04.003

    Article  PubMed  Google Scholar 

  27. van Tulder MW, Assendelft WJ, Koes BW, Bouter LM (1997) Method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group for Spinal Disorders. Spine 22:2323–2330

    Article  PubMed  Google Scholar 

  28. Waddell G, Burton AK (2001) Occupational health guidelines for the management of low back pain at work: evidence review. Occup Med (Lond) 51:124–135

    Article  CAS  Google Scholar 

  29. Waddell G, Newton M, Henderson I, Somerville D, Main CJ (1993) A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 52:157–168

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

This project was supported by the National Research Programme NRP 53 “Musculoskeletal Health - Chronic Pain” of the Swiss National Science Foundation (Project 405340-104826).

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, Section of Orthopaedic Surgery, Dunedin School of Medicine, University of Otago, Private Bag 1921, Dunedin, 9001, New Zealand

    M. Melloh & J. C. Theis

  2. Department of Work and Organizational Psychology, Institute of Psychology, University of Berne, Uni-Tobler, Muesmattstrasse 45, 3000, Berne 9, Switzerland

    A. Elfering, C. Egli Presland & C. Rolli Salathé

  3. Department of Evaluative Clinical Research, Institute for Evaluative Research in Orthopaedic Surgery, MEM Research Center, University of Berne, Stauffacherstrasse 78, 3014, Berne, Switzerland

    C. Roeder, O. Tamcan & U. Mueller

  4. Department of Orthopaedic Surgery, Asklepios Klinikum Uckermark, Auguststrasse 23, 16303, Schwedt/Oder, Germany

    T. Barz

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  1. M. Melloh
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  2. A. Elfering
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  4. C. Roeder
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  7. O. Tamcan
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  9. J. C. Theis
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Correspondence to C. Egli Presland.

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Melloh, M., Elfering, A., Egli Presland, C. et al. Identification of prognostic factors for chronicity in patients with low back pain: a review of screening instruments. International Orthopaedics (SICOT) 33, 301–313 (2009). https://doi.org/10.1007/s00264-008-0707-8

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  • DOI: https://doi.org/10.1007/s00264-008-0707-8

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