Burke Colleen A, Fillipo Rebecca, George Steven Z, Kapos Flavia P, Kosinski Andrzej S, Ford Emily, Danyluk Stephanie T, Kingsbury Carla A, Seebeck Kelley, Lewis Christopher E, Plez Cecilia, Brown Michael C, Goode Adam P
Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA.
Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA; Duke Clinical Research Institute, Duke University, Durham, NC, USA.
J Pain. 2025 Jan;26:104704. doi: 10.1016/j.jpain.2024.104704. Epub 2024 Oct 11.
The transition from acute to chronic low back pain (LBP) in community settings is not well understood. The purpose of this study was to assess the feasibility of recruitment and estimate the transition and continuation of chronic LBP. We also explored characteristics associated with this transition to chronic LBP. We enrolled n = 131 participants, of which n = 118 (90 %) completed 3-month outcomes and n = 111 (85 %) completed 6-month outcomes. Acute LBP was defined by a duration of < 4 weeks and a 30-day LBP-free period before the current acute episode. Chronic LBP was defined as pain most or every day over the past 3 months. The transition from acute to chronic LBP at 3 months was 32.2 % (38/118), and at 6 months, 80.6 % (25/31) of participants who transitioned at 3 months continued to have chronic LBP at 6 months. Participants with more frequent acute LBP and at an intensity of 30/100 were more likely to transition to chronic LBP (Risk Ratio (RR)= 3.13, 95 % Confidence Interval (CI) 1.84, 5.30) and continue to have chronic LBP at 6-months (RR=3.10, 95 % CI 1.48, 6.08). Higher risk on the STarT Back Screening Tool was associated with the transition to chronic LBP at 3 months (RR=1.73, 95 % CI 1.28, 2.35) and continuation of chronic LBP at 6 months (RR=1.26, 95 % CI 1.10, 1.45). The recruitment of acute LBP was feasible in a community setting. Acute LBP is a common condition in the community and frequently transitions to chronic LBP, suggesting the potential for substantial burden in the community. PERSPECTIVE: This article presents the feasibility of conducting a community-based study to describe the transition, continuation, and psychosocial predictors of acute to chronic low back pain. These findings could help identify community participants at high risk of incident and continued chronic low back pain.
在社区环境中，从急性腰痛（LBP）转变为慢性腰痛的情况尚未得到充分了解。本研究的目的是评估招募的可行性，并估计慢性腰痛的转变和持续情况。我们还探讨了与这种向慢性腰痛转变相关的特征。我们招募了n = 131名参与者，其中n = 118名（90%）完成了3个月的随访结果，n = 111名（85%）完成了6个月的随访结果。急性腰痛定义为持续时间<4周，且在当前急性发作前有30天无腰痛期。慢性腰痛定义为在过去3个月中大部分时间或每天都有疼痛。3个月时从急性腰痛转变为慢性腰痛的比例为32.2%（38/118），6个月时，在3个月时转变的参与者中有80.6%（25/31）在6个月时仍患有慢性腰痛。急性腰痛发作频率更高且疼痛强度为30/100的参与者更有可能转变为慢性腰痛（风险比（RR）= 3.13，95%置信区间（CI）1.84，5.30），并在6个月时继续患有慢性腰痛（RR = 3.10，95% CI 1.48，6.08）。STarT Back筛查工具得分较高与3个月时转变为慢性腰痛（RR = 1.73，95% CI 1.28，2.35）以及6个月时慢性腰痛的持续存在（RR = 1.26，95% CI 1.10，1.45）相关。在社区环境中招募急性腰痛患者是可行的。急性腰痛在社区中是一种常见病症，且经常转变为慢性腰痛，这表明在社区中可能会造成巨大负担。观点：本文介绍了开展一项基于社区的研究以描述急性腰痛向慢性腰痛的转变、持续情况以及心理社会预测因素的可行性。这些发现有助于识别有发生和持续慢性腰痛高风险的社区参与者。
