Clinical findings in a population with back pain. Relation to one-year outcome and long-term sick leave
1Linköping Spine Centre, Department of Orthopaedic Surgery, University Hospital, Sweden. tomas.reigo@lio.se
Objective:
To investigate whether physical examination findings can be used in predicting recovery from back pain and new episodes of sick leave.
Design:
One-year prospective study of a single cohort.
Settings:
Semi-rural Swedish county.
Population:
A cross-section of a general population with back pain (207 women, 176 men) between 20 and 59 years of age.
Main Outcome Measures:
Cumulative incidence of sick leave due to back pain, cumulative incidence of sick leave due to back pain > 30 days, incidence of recovery from back pain.
Results:
For recovery from pain, the absence of tenderness in the trapezius muscle (OR 0.33; CI 0.1-0.5) was predictive. New sick leave was predicted by tenderness in the trapezius muscle (OR 2.67; CI 1.5-4.9), and had a tendency to be associated with a flattened lumbar lordosis and a restricted cervical range of motion. For long-term sick leave, the same findings and also observation of scoliosis (OR 3.44; CI 1.1-10.5) were predictive.
Conclusion:
There are subgroups with back pain predisposed to development of more persistent symptoms and a higher risk for sick-listing.
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