LOGIN TO YOUR ACCOUNT

Username
Password
Remember Me
Or use your Academic/Social account:

CREATE AN ACCOUNT

Or use your Academic/Social account:

Congratulations!

You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.

Important!

Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message

CREATE AN ACCOUNT

Name:
Username:
Password:
Verify Password:
E-mail:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Kongsted, Alice; Kent, Peter; Axén, Iben; Downie, Aron S.; Dunn, Kate M. (2016)
Publisher: BioMed Central
Languages: English
Types: Article
Subjects: Debate, RA

Classified by OpenAIRE into

mesheuropmc: nervous system diseases

Background: Non-specific low back pain (LBP) is often categorised as acute, subacute or chronic by focusing on the duration of the current episode. However, more than twenty years ago this concept was challenged by a recognition that LBP is often an episodic condition. This episodic nature also means that the course of LBP is not well described by an overall population mean. Therefore, studies have investigated if specific LBP trajectories could be identified which better reflect individuals' course patterns. Following a pioneering study into LBP trajectories published by Dunn et al. in 2006, a number of subsequent studies have also identified LBP trajectories and it is timely to provide an overview of their findings and discuss how insights into these trajectories may be helpful for improving our understanding of LBP and its clinical management. Discussion: LBP trajectories in adults have been identified by data driven approaches in ten cohorts, and these have consistently demonstrated that different trajectory patterns exist. Despite some differences between studies, common trajectories have been identified across settings and countries, which have associations with a number of patient characteristics from different health domains. One study has demonstrated that in many people such trajectories are stable over several years. LBP trajectories seem to be recognisable by patients, and appealing to clinicians, and we discuss their potential usefulness as prognostic factors, effect moderators, and as a tool to support communication with patients. Conclusions: Investigations of trajectories underpin the notion that differentiation between acute and chronic LBP is overly simplistic, and we believe it is time to shift from this paradigm to one that focuses on trajectories over time. We suggest that trajectory patterns may represent practical phenotypes of LBP that could improve the clinical dialogue with patients, and might have a potential for supporting clinical decision making, but their usefulness is still underexplored.

  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Croft P, Altman DG, Deeks JJ, Dunn KM, Hay AD, Hemingway H, LeResche L, Peat G, Perel P, Petersen SE et al. The science of clinical practice: disease diagnosis or patient prognosis? Evidence about “what is likely to happen” should shape clinical practice. BMC Med. 2015;13:20.
    • 2. Hart LG, Deyo RA, Cherkin DC. Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey. Spine (Phila Pa 1976). 1995;20(1):11-9.
    • 3. Spitzer WO, LeBlanc FE, Dupuis M. Scientific approach to the assessment and management of activity-related spinal disorders. A monograph for clinicians. Report of the Quebec Task Force on Spinal Disorders. Spine. 1987; 12(7 Suppl):S1-59.
    • 4. Von Korff M, Saunders K. The course of back pain in primary care. Spine. 1996;21(24):2833-7.
    • 5. Von Korff M. Studying the natural history of back pain. Spine. 1994;19(18 Suppl):2041S-6.
    • 6. da C Menezes Costa L, Maher CG, Hancock MJ, McAuley JH, Herbert RD, Costa LO. The prognosis of acute and persistent low-back pain: a metaanalysis. CMAJ. 2012;184(11):E613-24.
    • 7. Pengel LH, Herbert RD, Maher CG, Refshauge KM. Acute low back pain: systematic review of its prognosis. BMJ. 2003;327(7410):323.
    • 8. Dunn KM, Jordan K, Croft PR. Characterizing the course of low back pain: a latent class analysis. Am J Epidemiol. 2006;163(8):754-61.
    • 9. Axen I, Leboeuf-Yde C. Trajectories of low back pain. Best Pract Res Clin Rheumatol. 2013;27(5):601-12.
    • 10. Dunn KM, Campbell P, Jordan KP. Long-term trajectories of back pain: cohort study with 7-year follow-up. BMJ Open. 2013;3(12):e003838.
    • 11. Kongsted A, Kent P, Hestbaek L, Vach W. Patients with low back pain had distinct clinical course patterns that were typically neither complete recovery nor constant pain. A Latent Class Analysis of longitudinal data. Spine J. 2015;15(5):885-94.
    • 12. Axen I, Bodin L, Bergstrom G, Halasz L, Lange F, Lovgren PW, Rosenbaum A, Leboeuf-Yde C, Jensen I. Clustering patients on the basis of their individual course of low back pain over a six month period. BMC Musculoskelet Disord. 2011;12:99.
    • 13. Chen C, Hogg-Johnson S, Smith P. The recovery patterns of back pain among workers with compensated occupational back injuries. Occup Environ Med. 2007;64(8):534-40.
    • 14. Tamcan O, Mannion AF, Eisenring C, Horisberger B, Elfering A, Muller U. The course of chronic and recurrent low back pain in the general population. Pain. 2010;150(3):451-7.
    • 15. Kent P, Kongsted A. Identifying clinical course patterns in SMS data using cluster analysis. Chiropr Man Therap. 2012;20(1):20.
    • 16. Macedo LG, Maher CG, Latimer J, McAuley JH, Hodges PW, Rogers WT. Nature and determinants of the course of chronic low back pain over a 12-month period: a cluster analysis. Phys Ther. 2014;94(2):210-21.
    • 17. Deyo RA, Bryan M, Comstock BA, Turner JA, Heagerty P, Friedly J, Avins AL, Nedeljkovic SS, Nerenz DR, Jarvik JG. Trajectories of symptoms and function in older adults with low back disorders. Spine (Phila Pa 1976). 2015;40(17):1352-62.
    • 18. Downie AS, Hancock MJ, Rzewuska M, Williams CM, Lin CC, Maher CG. Trajectories of acute low back pain: a latent class growth analysis. Pain. 2015;157:225-34.
    • 19. Dunn KM, Campbell P, Jordan KP. Visual trajectories: can people tell you their back pain trajectory? In: XIII International Back Pain Forum: 2014; Campos do Jordao, Brazil. 2014.
    • 20. Pincus T, Kent P, Bronfort G, Loisel P, Pransky G, Hartvigsen J. Twenty-five years with the biopsychosocial model of low back pain-is it time to celebrate? A report from the twelfth international forum for primary care research on low back pain. Spine (Phila Pa 1976). 2013;38(24):2118-23.
    • 21. Von Korff M, Dunn KM. Chronic pain reconsidered. Pain. 2008;138(2):267-76.
    • 22. Freynhagen R, Baron R, Gockel U, Tolle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006;22(10):1911-20.
    • 23. Nicholls E, Thomas E, van der Windt DA, Croft PR, Peat G. Pain trajectory groups in persons with, or at high risk of, knee osteoarthritis: findings from the Knee Clinical Assessment Study and the Osteoarthritis Initiative. Osteoarthr Cartil. 2014;22(12):2041-50.
    • 24. Holla JF, van der Leeden M, Heymans MW, Roorda LD, Bierma-Zeinstra SM, Boers M, Lems WF, Steultjens MP, Dekker J. Three trajectories of activity limitations in early symptomatic knee osteoarthritis: a 5-year follow-up study. Ann Rheum Dis. 2014;73(7):1369-75.
    • 25. Walton DM, Eilon-Avigdor Y, Wonderham M, Wilk P. Exploring the clinical course of neck pain in physical therapy: a longitudinal study. Arch Phys Med Rehabil. 2014;95(2):303-8.
    • 26. Dunn KM, Jordan KP, Mancl L, Drangsholt MT, Le Resche L. Trajectories of pain in adolescents: a prospective cohort study. Pain. 2011;152(1):66-73.
    • 27. de Vet HC, Heymans MW, Dunn KM, Pope DP, van der Beek AJ, Macfarlane GJ, Bouter LM, Croft PR. Episodes of low back pain: a proposal for uniform definitions to be used in research. Spine (Phila Pa 1976). 2002;27(21):2409-16.
  • No related research data.
  • No similar publications.

Share - Bookmark

Cite this article