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

Low back pain (LBP) is a leading cause of disability globally, with its impact amplified by the recurrent nature of the condition. It is unclear whether specific patient features are associated with future disability burden, following recovery from an episode of LBP. The current study explored prognostic factors of future disability over 12 months in patients recently recovered from an episode of LBP. Participants were adults from the no-intervention control group of the WalkBack trial. Fifteen candidate prognostic factors were collected at baseline. The outcome was disability, self-reported at 3, 6, 9 and 12 months using the Roland-Morris Disability Questionnaire and summarised as an area under the curve to quantify overall disability burden over 12 months. A single multivariable model was developed to identify prognostic factors. Three hundred and one of 350 control group participants (at least 3 of 4 disability measures available) were included. The sample had a mean age of 55 years, and most participants were female (81%). Higher body mass index (β = 0.27, 95% confidence interval [CI] 0.04-0.49; Kg/m2), worse pain intensity during the previous episode (β = 1.10, 95% CI 0.28-1.92; 0-10 scale), a higher perceived risk of recurrence (β = 0.71, 95% CI 0.14-1.28; 0-10 scale), and depressive symptoms (β = 0.61, 95% CI 0.18-1.05; 0-21 depression subscale) were associated with higher overall disability burden, controlling for other candidate prognostic factors. Each factor had a small, unique effect on overall disability. The findings inform risk assessment and prevention of future LBP-related disability. Perspective: The combination of psychological vulnerability, pain experience, and body composition is associated with future overall disability burden, even after apparent recovery from low back pain.