INFLUENCE OF PREVIOUS PAIN EXPERIENCE ON THE EPISODE INCIDENCE OF LOW-BACK-PAIN - RESULTS FROM THE SOUTH MANCHESTER BACK PAIN STUDY

Background: A pathological cause cannot be identified for most new epi sodes of low back pain (LBP) presenting to the general practitioner. O ne important potential influence on susceptibility is previous pain ex perience. To accurately investigate the contribution of this phenomeno n to the onset of new episodes of LBP a prospective population study i s required. Aims: To determine the relationship of prior pain in the b ack and other musculoskeletal sites to risk of subsequent new episodes of LBP. Methods: The population studied included all 2715 adults from the South Manchester Back Pain Study who were free of LBP during the month prior to the baseline survey, At baseline a detailed musculoskel etal pain history was obtained. New episodes of LBP over the subsequen t 12 months were ascertained by: (i) prospectively monitoring all prim ary care consultations in the study cohort (consulting episodes) and ( ii) a follow-up survey after 1 year to determine new episodes during t hat 12 month period not leading to consultation (non-consulting episod es), Results: The 12 month cumulative incidence of new consulting epis odes was 3% in males and 5% in females, and for new non-consulting epi sodes 31% in males and 32% in females, Those with a history of previou s LBP had twice the rate of new episodes, both consulting and non-cons ulting, compared to those with no LBP in the past, Neck pain or pain i n other musculoskeletal sites at baseline also doubled the risk of a s ubsequent new episode of LBP, Adjusting for psychological distress and the other pain variables had little influence on the findings. Conclu sion: In those currently free of LBP a previous history of the symptom substantially increases the risk of a further episode, with pain in o ther sites an equally strong independent predictor of subsequent LBP.