In a systematic review (a study that reviews other reviews to make sense of a large group of data), researchers looked for helpful predictors for people who go on to deal with persisting lower back pain.

Of the things they’ve delved into, which factors do you think influenced a person from an acute back pain episode to persisting pain? 

Well, it definitely wasn’t changes seen in imaging. Degenerative disk disease and bulging discs are weakly related to someone feeling symptoms.

Maladaptive coping behavior (e.g., ‘I’m afraid I’ll hurt my back if I move it,’ ‘I’ll damage my back more if I exercise’), nonorganic signs (e.g., exaggerated pain response), functional impairment (e.g., how capable are you of moving and using your body?), general health status (e.g., do you smoke?, are you obese?, have a sedentary lifestyle?, how active are you?, and psychiatric comorbidities (do you have a history of depression/anxiety/psychological issues?).

What do you think of all this?

Remember that an acute back pain episode will gradually go away on its own. Here’s a reminder on best guidelines for dealing with a back pain episode.

Chou R., Shekelle P. Will this patient develop persistent disabling low back pain?  2010 Apr 7;303(13):1295-302. doi: 10.1001/jama.2010.344.

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