What can we learn from long-term studies on chronic low back pain? A scoping review

Alisa L Dutmer; Remko Soer; André P Wolff; Michiel F Reneman; Maarten H Coppes; Henrica R Schiphorst Preuper

doi:10.1007/s00586-022-07111-3

What can we learn from long-term studies on chronic low back pain? A scoping review

Eur Spine J. 2022 Apr;31(4):901-916. doi: 10.1007/s00586-022-07111-3. Epub 2022 Jan 19.

Authors

Alisa L Dutmer¹, Remko Soer^{1

2

3}, André P Wolff^{3

4}, Michiel F Reneman⁵, Maarten H Coppes⁶, Henrica R Schiphorst Preuper^{1

3}

Affiliations

¹ Department of Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
² Expertise Center of Health and Movement, Saxion University of Applied Sciences, Enschede, The Netherlands.
³ University Medical Center Groningen, Pain Center, University of Groningen, Groningen, The Netherlands.
⁴ Department of Anesthesiologie, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁵ Department of Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. m.f.reneman@umcg.nl.
⁶ Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

PMID: 35044534
DOI: 10.1007/s00586-022-07111-3

Abstract

Purpose: A scoping review was conducted with the objective to identify and map the available evidence from long-term studies on chronic non-specific low back pain (LBP), to examine how these studies are conducted, and to address potential knowledge gaps.

Method: We searched MEDLINE and EMBASE up to march 2021, not restricted by date or language. Experimental and observational study types were included. Inclusion criteria were: participants between 18 and 65 years old with non-specific sub-acute or chronic LBP, minimum average follow-up of > 2 years, and studies had to report at least one of the following outcome measures: disability, quality of life, work participation, or health care utilization. Methodological quality was assessed using the Effective Public Health Practice Project quality assessment. Data were extracted, tabulated, and reported thematically.

Results: Ninety studies met the inclusion criteria. Studies examined invasive treatments (72%), conservative (21%), or a comparison of both (7%). No natural cohorts were included. Methodological quality was weak (16% of studies), moderate (63%), or strong (21%) and generally improved after 2010. Disability (92%) and pain (86%) outcomes were most commonly reported, followed by work (25%), quality of life (15%), and health care utilization (4%). Most studies reported significant improvement at long-term follow-up (median 51 months, range 26 months-18 years). Only 10 (11%) studies took more than one measurement > 2 year after baseline.

Conclusion: Patients with persistent non-specific LBP seem to experience improvement in pain, disability and quality of life years after seeking treatment. However, it remains unclear what factors might have influenced these improvements, and whether they are treatment-related. Studies varied greatly in design, patient population, and methods of data collection. There is still little insight into the long-term natural course of LBP. Additionally, few studies perform repeated measurements during long-term follow-up or report on patient-centered outcomes other than pain or disability.

Keywords: Chronic low back pain; Disability; Long-term follow-up; Quality of life; Scoping review; Work participation.

Publication types

Review

MeSH terms

Adolescent
Adult
Aged
Chronic Pain* / therapy
Humans
Longitudinal Studies
Low Back Pain* / therapy
Middle Aged
Observational Studies as Topic
Quality of Life
Young Adult