Predicting Low Back Pain
In this study, researchers asked the question, Does minor trauma increase the risk of serious low back pain (LBP)? They report the answer is No. This was the case even for people with risk factors for degenerative lumbar disc disease but no previous episodes of LBP.
Two hundred (200) working adults with no history of serious LBP problems were followed for five years. Half the group had chronic pain somewhere else in the body. These patients were included because previous studies have shown an increased risk of disabling LBP in people with chronic nonlumbar pain.
Everyone was tested for structural changes of the spine. Physical exam, X-rays, and MRIs were done of the lumbar spine. Rechecks were done every six months. New MRIs were ordered anytime someone had persistent LBP. MRI results were compared with the baseline studies.
Serious LBP was more likely to occur with daily activity or from no known cause. Minor trauma was not linked with corresponding serious LBP. Subjects in this study with structural changes in the spine were not more likely to have LBP after minor trauma. Structural changes refers to degenerative changes in the spinal segments, especially disc disease.
The results of this study support previous research that points to patient social, behavioral, and psychological factors as being far more predictive of LBP. Psychologic distress, smoking, and previous compensation issues were better predictors of serious LBP and disability than minor trauma -- even in the presence of degenerative disc disease.
Eugene Carragee, MD, et al. Does Minor Trauma Cause Serious Low Back Illness? In Spine. December 1, 2006. Vol. 31. No. 25. Pp. 2942-2949.