Predictors of longitudinal symptom trajectory in young adults with low back pain

Predictors of longitudinal symptom trajectory in young adults with low back pain. Severity and frequency of painful episodes change over time in individuals with chronic low back pain (LBP). Recalling previous episodes’ severity/frequency is often considered inaccurate. This study’s purpose was to determine if recall of LBP history or psychological characteristics are predictors of future symptom trajectories in young adults with LBP. The 57 young adult participants had a year or more history of LBP and were not currently in pain. At baseline, LBP history was characterized by recall of pain severity and frequency during symptomatic episodes. Participants completed measures of anxiety, depression, and fear avoidance beliefs. Pain trajectories were tracked via survey every 2 months for 18 months, where participants identified average and worst pain symptoms. Participants were placed into groups based on pain trajectories over the follow-up period using latent class analysis (LCA). Logistic regression was used to identify if LBP history or psychological traits were predictors of average and worst pain trajectories. Survey completion rate was 95%. LCA found two sub-groups for both average and worst pain trajectories, where individuals in the adverse trajectory group had greater severity and frequency of episodes than the less adverse group (p < 0.01 for both comparisons). Predictors of more adverse average pain were typical pain (p = 0.01) and frequency of symptoms (p = 0.02) at baseline, and depression score (p = 0.04) (percentage accuracy in classification (PAC) 84.9%, omnibus p = 0.0004). Predictors of more adverse worst pain were typical pain (p = 0.05) and depression at baseline (p = 0.02) (PAC 69.8%, p = 0.02). Even during no pain, self-report of past pain history is predictive of future LBP episodes. To enhance LBP management, it is essential to determine factors that predict symptom fluctuation across the lifespan. As depression is linked with more adverse history of LBP over time, clinicians should assess psychological traits in young adults with chronic pain.