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Updated: Jan 10, 2026

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
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Risk factors and interaction effects in recurrent low back pain.

Lin Wang1, Zhiming Mao2, Huiyuan Huang2

  • 1Department of Neurology, The 924th Hospital of The People's Liberation Army Joint Logistic Support Force Guilin 541000, Guangxi Zhuang Autonomous Region, China.

American Journal of Translational Research
|November 21, 2025
PubMed
Summary

Elevated white blood cell count, anxiety, and long working hours are key predictors of low back pain recurrence. A new nomogram helps predict recurrence risk, aiding personalized interventions.

Keywords:
Low back paininteractionrecurrence mechanismrisk factors

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Area of Science:

  • Orthopedics and Sports Medicine
  • Pain Management
  • Epidemiology

Background:

  • Low back pain (LBP) is a prevalent condition with significant recurrence rates.
  • Identifying predictive factors for LBP recurrence is crucial for effective management and prevention strategies.
  • Understanding interactions between risk factors can refine predictive models.

Purpose of the Study:

  • To identify independent risk factors for low back pain recurrence.
  • To develop and validate a predictive model (nomogram) for LBP recurrence.
  • To investigate interaction effects among identified risk factors.

Main Methods:

  • Retrospective cohort study with derivation (n=216) and external validation (n=46) cohorts.
  • Screening of independent risk factors using univariate, Lasso, and multivariate logistic regression.
  • Evaluation of interaction effects and construction/validation of a nomogram.

Main Results:

  • The 1-month LBP recurrence rate was 33.8%.
  • Independent predictors included elevated white blood cell (WBC) count, anxiety, working >8 h/day, and elevated interleukin-1β (IL-1β).
  • Significant interactions were found between BMI and working hours, WBC and anxiety, and anxiety and working hours.

Conclusions:

  • Elevated WBC, IL-1β, anxiety, and prolonged working hours are significant predictors of LBP recurrence.
  • Interactions among these factors influence recurrence risk.
  • The developed nomogram provides excellent discrimination for personalized risk stratification and guides interventions.