Risk factors and interaction effects in recurrent low back pain

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.