375: Prognostic factors of future disability following recovery from an episode of low back pain

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Acute musculoskeletal pain, Developing methodology/technology, Epidemiology, Treatment/management

Background and Aims: Low back pain (LBP) is a highly prevalent symptom worldwide. The recurrence nature of LBP is a major contributor to the impact experienced by individuals. Research has typically examined the recurrence of LBP as an isolated event rather than considering the impact to a repeating pattern over time. It is unclear whether specific patient features could be associated with a future disability following recovery from an episode of LBP. The current study aimed to explore candidate prognostic factors of future disability over the 12 months following recovery from an episode of LBP.

Methods: This is a secondary analysis of the WalkBack study, examining the data from the untreated control arm. Eligible participants were adults who had recently recovered from an episode of LBP. Fifteen candidate prognostic factors measured at baseline were included. The outcome was disability level, self-reported at 3, 6, 9 and 12 months using the Roland-Morris Disability Questionnaire. A summary measure (area under the curve, AUC) was used to assess the overall disability burden over the 12-months. Each factor was initially assessed in a univariable model, and a single multivariable model was developed. We reported unstandardised beta coefficients and their corresponding confidence intervals.

Results: A total of 301 out of 350 participants from the WalkBack control group were included in the study. Higher body mass index (β = 0.27, 95% CI 0.04 to 0.49; p = 0.020), worse pain during the previous episode (β = 1.10, 95% CI 0.28 to 1.92; p = 0.008), a higher perceived risk of recurrence (β = 0.71, 95% CI 0.14 to 1.28; p = 0.016), and symptoms of depression (β = 0.61, 95% CI 0.18 to 1.05; p = 0.006) were consistently associated with higher overall disability burden, controlling for the other candidate prognostic factors. Eleven factors were not significantly associated with the outcome.

Conclusions: This study explored candidate prognostic factors associated with the cumulative burden of disability over 12 months following recovery from an episode of LBP. Using a novel summary measure that integrated repeated disability assessments over time, we found that higher body mass index, worse pain during the previous episode, higher perceived risk of recurrence, and more severe symptoms of depression were independently associated with greater future disability burden. Each of the four prognostic factors had a small but potentially meaningful unique effect on overall disability burden.

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Presenting Author: Leandro Calazans Nogueira
Submitting Author: Leandro Calazans Nogueira

Senior Author: Mark Hancock

IASP 2026 Global Year theme of Neuropathic Pain: No

• Natasha Pocovi: PhD - Macquarie University
• Aron Downie: PhD - Macquarie University
• Alice Kongsted: PhD - University of Southern Denmark
• Mark Hancock: PhD - Macquarie University