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Chiropractic Research Review

Can Psychological Stress Cause LBP a Decade Later?

There are numerous variables involved in low back pain (LBP), including physical, psychosocial, and personal characteristics. These factors usually are based on the current working life of subjects; little research has focused on the effect of previous experiences on later LBP.



Five hundred seventy-one British subjects with an initial onset of LBP at 32-33 years of age were compared to 5,210 controls who did not suffer from the condition. Backache information related to multiple factors was taken from a current questionnaire and another completed 10 years previously. Only those with no LBP at age 23, but with later onset, were considered. Psychological distress at age 23 was determined using the 24-item Malaise Inventory.

Results: Ten percent of subjects with no prior pain reported incident LBP when older. Subjects who were psychologically distressed at age 23 were 2.52 times more likely to have LBP a decade later. Smoking 10 or more cigarettes per day throughout the 10 years increased LBP incidence 1.63 times. No other factors were significantly associated with LBP.
"Our study was unique in its inclusion of risk factors from early life in relation to pain onset in early adulthood," the authors write.

Approximately 43% of the original sample was excluded because they suffered LBP prior to age 32. As such, these risk factors may not apply to those with the most "frail" backs and ongoing pain.

Power C, Frank J, Hertzman C, et al. Predictors of low back pain onset in a prospective British study. American Journal of Public Health 2001:91(10), pp. 1671-1678.

Chiropractic Research Review

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