A prospective study of the effects of sexual or physical abuse on back pain

A prospective investigation of the effects of abuse on future pain and disability was conducted in order to understand better the possible causal role of abuse. Participants were 422 females from a previous population study (Pain 73 (1997) 47-53) who either reported no spinal pain (n=194) or some spinal pain (n=228) at the baseline. A standardized questionnaire was used to assess self-reported physical and sexual abuse during childhood and as an adult. One year later, a follow-up questionnaire was used to evaluate pain and physical function outcomes. Results for the No Pain Group showed that only self-reported physical abuse at baseline was associated with an increased occurrence of new episodes of back pain (odds RATIO=2.65). Both sexual and physical abuse were linked to as much as four-fold increase in the occurrence of a new episode of functional problems at follow-up. However, for the Pain Group, no significant differences were found between those reporting and not reporting abuse at baseline and either pain or disability at follow-up. This unique prospective study with individuals from the general population underscores the probable importance of abuse in the etiology of a pain or disability problem. Nevertheless, since no clear relationship between abuse and pain was shown for those already reporting pain at baseline, the role of abuse in the development of persistent pain is still not comprehensible. There is a need for investigations with prospective designs employing patients as well as nonpatients as subject.