What is the personal impact of recurrences of low back pain? Subanalysis of an inception cohort study

Objective: To investigate (1) the impact of low back pain (LBP) over the course of 1 year in people recently recovered from an episode of LBP, (2) whether the impact differs in people who do and do not experience a recurrence, and (3) the impact of LBP based on 3 definitions of a recurrence of LBP. Design: Cohort study. Methods: In 250 individuals recently recovered from LBP, the impact of LBP over the previous 3 months was assessed with the impact score, a multidimensional measure (range, 8-50), at 3, 6, 9, and 12 months. Recurrence of LBP was assessed monthly and defined as a recurrence of an episode of LBP, a recurrence of activity-limiting LBP, or a recurrence of LBP causing patients to seek care. Results: The median impact over 1 year was 11.5 points (interquartile range, 9.5-14.8). The impact was 15.2 points (95% confidence interval [CI]: 13.9, 16.3) for those who reported any recurrence and 11.1 points (95% CI: 10.6, 11.5) for those who did not. When comparing definitions of recurrence, those who had a recurrence that did not cause moderate activity limitation or result in care seeking had an overall impact of 12.7 points (95% CI: 11.6, 13.8). Participants who had recurrences of activity-limiting LBP but did not seek care, had an overall impact of 15.5 points (95% CI: 13.5, 17.6), and those who had recurrences of LBP for which health care was sought had an overall impact of 16.9 points (95% CI: 15.3, 18.4). Conclusion: The average impact due to recurrence of LBP was low and dependent on the definition of recurrence.