Triggers for an episode of sudden onset low back pain: study protocol

Paulo H Ferreira,Bart W Koes,Christopher G Maher,Fiona M Blyth,Daniel Steffens,Manuela L Ferreira,Jane Latimer

doi:10.1186/1471-2474-13-7

Abstract

BackgroundMost research on risk factors for low back pain has focused on long term exposures rather than factors immediately preceding the onset of low back pain. The aim of this study is to quantify the transient increase in risk of a sudden episode of low back pain associated with acute exposure to a range of common physical and psychological factors.Methods/designThis study uses a case-crossover design. One thousand adults with a sudden onset of low back pain presenting to primary care clinicians will be recruited. Basic demographic and clinical information including exposure to putative triggers will be collected using a questionnaire. These triggers include exposure to hazardous manual tasks, physical activity, a slip/trip or fall, consumption of alcohol, sexual activity, being distracted, and being fatigued or tired. Exposures in the case window (0-2 hours from the time when participants first notice their back pain) will be compared to exposures in two control time-windows (one 24-26 hours and another 48-50 hours before the case window).DiscussionThe completion of this study will provide the first-research based estimates of the increase in risk of a sudden episode of acute low back pain associated with transient exposure to a range of common factors thought to trigger low back pain.

Highlights

Most research on risk factors for low back pain has focused on long term exposures rather than factors immediately preceding the onset of low back pain
Nearly 4 million people in Australia suffer from back pain at any one time [1], with total treatment costs exceeding $1 billion a year [2]
Study Participants One thousand consecutive patients presenting to primary care clinicians for treatment of an episode of sudden onset, acute, low back pain will be recruited in Sydney, Australia

Summary

Introduction

Most research on risk factors for low back pain has focused on long term exposures rather than factors immediately preceding the onset of low back pain. Back complaints are the seventh most common condition in patients consulting general practitioners in Australia, and the most common musculoskeletal condition [4] It is the most common health problem for which an imaging test is ordered by a general practitioner [4]. A potential solution to managing the problem of low back pain is the identification and control of modifiable risk factors. This approach is appealing and seemingly logical and there are notable examples where such an approach has provided major improvements in public health. For back pain this approach has not yet been

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Conclusion