The progression from acute to chronic low back pain: a systematic review of risk factors and practice recommendations
Sheehan, Willow Anne
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Acute low back pain (LBP) is common and can lead to chronic LBP. Chronic LBP carries the risk of significant financial burden and reduced quality of life. If low back pain persists beyond six weeks, the likelihood of recovery is limited. Therefore, it would be beneficial to identify those acute LBP patients most at risk of progressing to chronic LBP early in the disease process. This project seeks to identify acute LBP risk factors (RFs) that are most predictive of chronic LBP in primary care populations. A systematic review of literature was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Article review resulted in the inclusion of 13 studies with 3,641 subjects, evaluating 104 RFs. Data extraction and analysis based on the review protocol resulted in clinical practice and future research recommendations. Coping by catastrophizing and the patient's perspective of risk of chronicity are the most well-supported RFs identified and can be safely assessed in clinical practice for the purpose of recognizing those acute LBP patients most at risk of chronicity and in need of early intervention. An additional 82 RFs are discussed for their value in future research and potential implications for future clinical practice.