Clinical Course and Prognostic Factors of Older Patients With Back Pain and Radiating Leg Pain in General Practice: BACE Cohort Study

Author:

Khorami A. Khoshal1ORCID,Koes Bart W.12,Heymans Martijn W.3,van der Gaag Wendelien H.1,Bindels Patrick J. E.1,Chiarotto Alessandro1ORCID

Affiliation:

1. Department of General Practice Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands

2. Center for Muscle and Joint Health University of Southern Denmark Odense Denmark

3. Department of Epidemiology and Data Science Amsterdam University Medical Center Location VUmc Amsterdam The Netherlands

Abstract

ABSTRACTObjectivePatients with back pain (BP) and radiating leg pain have poorer clinical outcomes compared to patients with BP alone. We aimed to describe the 1‐year clinical course and to identify prognostic factors associated with non‐recovery in older BP patients with radiating leg pain.DesignPatients in the BACE cohort aged >55 years with a new episode of BP and radiating leg pain were included (n = 377). Data on clinical outcomes were collected until 1‐year follow‐up. Uni‐ and multivariable regression analyses were performed to investigate the association between potential prognostic factors and three non‐recovery outcomes at the 1‐year follow‐up.ResultsMore than half of the patients (65%) did not recover after 12 months. In multivariable analyses, poor self‐rated health (odds ratio [OR] 2.34, 95% CI: 1.20–4.56) and BP duration at baseline (OR 1.48, 1.12–1.96) were significantly associated with non‐recovery for BP as outcome; age (OR 1.04, 1.03–1.05), smoking (OR 1.14, 1.00–1.30), depressive symptomatology (OR 1.03, 1.02–1.04), kinesiophobia (OR 1.03, 1.02–1.04), poor self‐rated health (OR 2.09, 1.83–2.39), baseline disability (OR 1.16, 1.14–1.17), BP duration (OR 1.49, 1.41–1.57), leg pain (OR 1.52, 1.37–1.68), pain during rotation (OR 1.71, 1.53–1.90) and other musculoskeletal complaints (OR 1.34, 1.17–1.52) were associated with disability. No factors were associated with leg pain.ConclusionsSeveral prognostic factors were associated with non‐recovery in older patients with BP and radiating leg pain. Primary care clinicians should be aware of these factors in managing these patients.

Funder

Erasmus Medisch Centrum

Publisher

Wiley

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