Article Figures & Data
Figures
- Figure 1.
Flowchart of the initial patient recruitment process.
- Figure 2.
Clinical course. A: Average back pain in the previous week, mean ± SD; NRS, numeric rating scale (range 0 to 10). B: Disability in the previous week, mean ± SD; RMDQ, Roland Morris disability questionnaire (range 0 to 24). C: Quality of life on the physical (blue) and mental (red) summary scales, mean ± SD; SF-36, Short Form-36, physical and mental summary scale (range 0 to 100).
- Figure 3.
Medical consumption. A: Self-reported use of medication (% patients using this type of medication from all patients using medication). B: Self-reported consultations of health care professionals (% of total response). C: Self-reported diagnostic referrals (% of total response).
Tables
Characteristics All values, n = 675 General Age in years, mean ± SD 66.4 ± 7.6 Male, n (%) 274 (41) BMI, mean ± SD 27.5 ± 4.7 <Low education level, n (%) 279 (41) Smoking, n (%) 122 (18) Back pain Duration of back pain, n (%) <1 week 62 (9) 1 week–6 weeks 273 (40) 6 weeks–3 months 104 (15) >3 months 156 (23) Average back pain previous week (NRS), mean ± SD 5.2 ± 2.7 Radiating pain in the leg below the knee, n (%) 205 (30) Disability (RMDQ), mean ± SD 9.8 ± 5.8 History of back pain, n (%) 579 (86) Back surgery in the past, n (%) 56 (8) Comorbidity musculoskeletal complaints, n (%) 519 (77) Medical consumption Use of pain medication for back pain, n (%) 485 (72) Care from a physical therapist, n (%) 299 (44) Psychological factors Patients' expectation to recover of back pain, n (%) 291 (43) Quality of life (SF-36) physical summary scale, mean ± SD 43.2 ± 8.9 Quality of life (SF-36) mental summary scale, mean ± SD 49.6 ± 10.3 Depressive symptomatology (CES-D), mean ± SD 10.0 ± 7.8 Kinesiophobia (FABQ), physical activity subscale, mean ± SD 13.4 ± 5.8 Pain catastrophizing (PCS), mean ± SD 14.1 ± 10.6 Attitude and beliefs about back pain (BBQ), mean ± SD 26.4 ± 7.2 ↵* BMI, body mass index (kg/m2); CI, confidence interval; NRS, numeric rating scale (range, 0 to 10); RMDQ, Roland Morris disability questionnaire (range, 0 to 24); SF-36, Short Form-36; physical and mental summary scale (range, 0 to 100); CES-D, Center for Epidemiologic Studies Depression Scale (range, 0 to 60); FABQ, Fear-avoidance beliefs questionnaire, physical subscale (range, 0 to 28); PCS, Pain Catastrophizing Scale (range, 0 to 52); BBQ, Back beliefs questionnaire (range, 9 to 45).
Outcomes Follow-up time Baseline, n = 675 3 months, n = 626 6 months, n = 612 9 months, n = 585 1 year, n = 591 2 years, n = 501 3 years, n = 429 4 years, n = 392 5 years, n = 392* Five-year clinical course, mean (± SD) Average back pain previous week (NRS) 5.2 (2.7) 3.6 (2.8) 3.4 (2.8) 3.4 (2.9) 3.3 (2.8) 3.2 (2.9) 3.4 (2.9) 3.2 (2.9) 3.0 (2.9) Disability (RMDQ) 9.8 (5.8) 7.8 (6.2) 7.2 (6.1) 7.2 (6.4) 6.9 (6.4) 7.0 (6.4) 7.2 (6.4) 7.0 (6.4) 6.7 (6.2) Quality of life (SF-36) physical summary scale 43.2 (8.9) 47.0 (10.2) 48.0 (10.3) 48.0 (10.2) 48.1 (10.3) 48.0 (10.4) 48.1 (10.4) 48.1 (10.1) 48.7 (9.8) Quality of life (SF-36) mental summary scale 49.6 (10.3) 49.5 (10.0) 49.9 (9.4) 49.7 (9.6) 50.1 (9.4) 49.1 (10.3) 49.5 (9.7) 49.5 (9.9) 48.9 (10.1) Recovery, n (%) N/A 239 (38) 243 (40) 220 (38) 228 (39) 195 (39) 177 (41) 166 (42) 170 (43) Medical consumption, n (%) Use of medication for back pain 485 (72) 245 (39) 205 (33) 196 (34) 178 (30) 157 (31) 138 (32) 116 (30) 98 (25) Paracetamol 236 (49) 126 (51) 116 (57) 121 (62) 109 (61) 79 (50) 80 (58) 71 (61) 56 (57) NSAIDs 277 (57) 106 (43) 89 (43) 78 (40) 65 (37) 63 (40) 52 (38) 45 (39) 44 (45) Opioids 82 (17) 51 (21) 35 (17) 31 (16) 31 (17) 42 (27) 38 (28) 26 (22) 25 (26) Muscle relaxants, sleep medication 37 (8) 11 (4) 12 (6) 4 (2) 5 (3) 3 (2) 4 (3) 7 (6) 0 (0) Antidepressants 5 (1) 7 (3) 4 (2) 4 (2) 4 (2) 6 (4) 6 (4) 4 (3) 1 (1) Antiepileptics 4 (1) 4 (2) 5 (2) 6 (3) 5 (3) 1 (1) 4 (3) 2 (2) 5 (5) Other 10 (2) 10 (4) 7 (3) 10 (5) 8 (4) 7 (4) 5 (4) 6 (5) 7 (7) Care from healthcare professionals Care from a GP N/A 161 (26) 75 (12) 68 (12) 57 (10) 71 (14) 34 (8) 38 (10) 37 (9) Care from a physical therapist 299 (44) 220 (35) 145 (24) 105 (18) 103 (17) 92 (18) 79 (18) 61 (16) 57 (15) Care from a medical specialist 46 (7) 68 (11) 56 (9) 49 (8) 45 (8) 40 (8) 32 (7) 25 (6) 25 (6) Examinations related to back complaints X-ray N/A 183 (29) 57 (9) 39 (7) 30 (5) 37 (7) 20 (5) 17 (4) 18 (5) Blood tests 92 (14) 82 (13) 46 (8) 34 (6) 26 (4) 32 (6) 25 (6) 29 (7) 25 (6) MRI/CT 30 (4) 42 (7) 41 (7) 25 (4) 27 (5) 29 (6) 23 (5) 15 (4) 16 (4) ↵* Due to missing values (range, 0% to 15%) these numbers may vary for different questions. NRS, numeric rating scale (range, 0 to 10); RMDQ, Roland Morris disability questionnaire (range, 0 to 24); SF-36, Short Form-36, physical and mental summary scale (range, 0 to 100); SD, standard deviation; NSAIDs, Nonsteroidal anti-inflammatory drugs; GP, general practitioners MRI, magnetic resonance imaging; CT, computed tomography. Percentages: % from total number of participants; except for the different types of pain medication: % of total amount of pain medication users.
