TY  - JOUR
AU  - Nordstoga, A. L.
AU  - Nilsen, T. I. L.
AU  - Vasseljen, O.
AU  - Unsgaard-Tondel, M.
AU  - Mork, P. J.
PY  - 2017
DA  - 2017//
TI  - The influence of multisite pain and psychological comorbidity on prognosis of chronic low back pain: longitudinal data from the Norwegian HUNT Study
T2  - BMJ Open
JO  - BMJ Open
SP  - e015312
VL  - 7
IS  - 5
KW  - back pain
KW  - epidemiology
KW  - musculoskeletal disorders
KW  - spine
AB  - OBJECTIVES: This study aimed to investigate the prospective influence of multisite pain, depression, anxiety, self-rated health and pain-related disability on recovery from chronic low back pain (LBP). SETTING: The data is derived from the second (1995-1997) and third (2006-2008) wave of the Nord-Trondelag Health Study (HUNT) in Norway. PARTICIPANTS: The study population comprises 4484 women and 3039 men in the Norwegian HUNT Study who reported chronic LBP at baseline in 1995-1997. PRIMARY OUTCOME MEASURES: The primary outcome was recovery from chronic LBP at the 11-year follow-up. Persons not reporting pain and/or stiffness for at least three consecutive months during the last year were defined as recovered. A Poisson regression model was used to estimate adjusted risk ratios (RRs) with 95% CIs. RESULTS: At follow-up, 1822 (40.6%) women and 1578 (51.9%) men reported recovery from chronic LBP. The probability of recovery was inversely associated with number of pain sites (P-trend<0.001). Compared with reporting 2-3 pain sites, persons with only LBP had a slightly higher probability of recovery (RR 1.10, 95% CI 0.98 to 1.22 in women and RR 1.10, 95% CI 1.01 to 1.21 in men), whereas people reporting 6-9 pain sites had substantially lower probability of recovery (RR 0.58, 95% CI 0.52 to 0.63 in women and RR 0.70, 95% CI 0.63 to 0.79 in men). Poor/not so good self-rated general health, symptoms of anxiety and depression, and pain-related disability in work and leisure were all associated with reduced probability of recovery, but there was no statistical interaction between multisite pain and these comorbidities. CONCLUSIONS: Increasing number of pain sites was inversely associated with recovery from chronic LBP. In addition, factors such as poor self-rated health, psychological symptoms and pain-related disability may further reduce the probability of recovery from chronic LBP.
SN  - 2044-6055
UR  - http://www.ncbi.nlm.nih.gov/pubmed/28592580
UR  - https://doi.org/10.1136/bmjopen-2016-015312
DO  - 10.1136/bmjopen-2016-015312
LA  - English
N1  - PMID:28592580; PMCID:PMC5734202
ID  - Nordstoga_etal2017
ER  -