Characterizing Acute Low Back Pain in a Community-Based Cohort: Results from a Feasibility Cohort Study

Colleen A Burke,1,2,&ast; Kenneth A Taylor,1,3,&ast; Rebecca Fillipo,2 Steven Z George,1– 3 Flavia P Kapos,1,3 Stephanie T Danyluk,1 Carla A Kingsbury,4 Kelley Seebeck,1 Christopher E Lewis,4 Emily Ford,4 Cecilia Plez,4 Andrzej S Kosinski,5 Michael C Brown,6,7 Adam P Goode1– 3 1Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; 2Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; 3Duke Clinical Research Institute, Duke University, Durham, NC, USA; 4Duke Clinical and Translational Science Institute, Duke University School of Medicine, Durham, NC, USA; 5Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA; 6Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA; 7Duke Cancer Institute, Duke University, Durham, NC, USA&ast;These authors contributed equally to this workCorrespondence: Adam P Goode, Department of Orthopedic Surgery, Duke University School of Medicine, 311 Trent Drive, Durham, NC, 27710, USA, Tel +1 919 681 6157, Fax +1 919 684 1846, Email adam.goode@duke.eduIntroduction: Acute low back pain (LBP) is a common experience; however, the associated pain severity, pain frequency, and characteristics of individuals with acute LBP in community settings have yet to be well understood. In this manuscript, two acute-LBP severity categorization definitions were developed: 1) pain impact frequency (impact-based) and 2) pain intensity (intensity-based) severity categories. The purpose of this manuscript is to describe and then compare these acute-LBP severity groups in the following characteristics: 1) sociodemographic, 2) general and physical health, and 3) psychological using a feasibility cohort study.Methods: This cross-sectional study used baseline data from 131 community-based participants with acute LBP (< 4 weeks duration before screening and ≥ 30 pain-free days before acute LBP onset). Descriptive associations were calculated as prevalence ratios of categorical variables and Hedges’ g for continuous variables.Results: Our analyses identified several large associations for impact-based and intensity-based categories with global mental health, global physical health, STarT Back Screening Tool risk category, and general health. Larger associations were found with social constructs (racially and ethnically minoritized, performance of social roles, and isolation) when using the intensity-based versus impact-based categorization.Discussion: This study adds to the literature by providing standard ways to characterize community-based individuals experiencing acute-LBP. The robust differences observed between these categorization approaches suggest that how we define acute-LBP severity is consequential; these different approaches may be used to improve the early identification of factors potentially contributing to the development of chronic-LBP.Keywords: low back pain, acute pain, cohort study, community