Does Combining the STarT Back Tool With a Polygenic Risk Score for Chronic Low Back Pain Improve Prediction of Work...

Area of Science:

• Genetics
• Epidemiology
• Pain Management

Background:

• Chronic back pain (CBP) is a major cause of global work disability.
• Identifying individuals at risk for CBP is challenging due to its complex origins.

Purpose of the Study:

• To assess if combining a polygenic risk score (PRS) for CBP with the STarT Back Tool (SBT) enhances prediction of work disability.
• To evaluate the utility of integrating genetic and psychosocial data for CBP risk stratification.

Main Methods:

• Analysis of 1938 participants from the Northern Finland Birth Cohort 1966.
• Utilized a zero-inflated negative binomial regression model for disability leave days.
• Integrated CBP PRS with SBT screening data and registry-linked disability records.

Main Results:

• Both SBT and CBP genetic risk independently predicted disability leave days.
• CBP genetic risk specifically predicted the burden of disability among affected individuals.
• The highest genetic risk quartile showed significantly more work disability days.

Conclusions:

• SBT and CBP PRS capture distinct, complementary risk domains (modifiable vs. fixed).
• Integrating CBP PRS into screening frameworks can improve early CBP management.
• Combined genetic and psychosocial assessment enhances risk stratification for disabling back pain.