How Do Pain-Response Patterns Influence the Course of Acute Low Back Pain? A Longitudinal Cohort Study

Abstract Background Pain-response patterns influence the daily activities and behavior of patients with low back pain (LBP). They are also a potential risk factor for pain persistence. Previous studies identified three subgroups of pain-response patterns: avoidance, endurance, and adaptive. In this study, we investigated the interaction effects of distinct pain-response patterns on pain intensity, disability and movement control impairment (MCI). Methods The 66 participants in this prospective cohort study had acute LBP, assessed at four time points over 6 months. Demographic, clinical and psychosocial data were collected, and MCI was examined.Results The results showed no significant between-group interactions of the different pain-response patterns with pain intensity, disability or MCI. However, within-group decreases in pain intensity and the disability level from the acute to the subacute phase were identified. In addition, the relative risk of persistent LBP was higher in the endurance response subgroup than in the adaptive subgroup at 6 months. MCI remained stable and at a low level throughout the observation period and did not correlate with pain or disability.Conclusions Screening for pain-response patterns may lead to a better understanding of patients’ underlying motivation in the broader context of their valued goals. Our findings provide further evidence of altered movement control throughout the course of LBP and thus the importance of early interventions. However, MCI tests allowing more subtle assessments of movement control are needed. Finally, patients with an acute episode of LBP may benefit from a multidimensional clinical approach that takes into account both physical and psychological health.