Mechanisms of lower back pain

Abstract

This thesis focuses on evaluating the mechanisms of low back pain in relation to risk, prognosis and response to treatment. The identification, or better understanding, of factors that increase the risk for the development of back pain, or that are associated with prognosis or response to treatment, is crucial for developing and refining prevention and management strategies. To contribute to the body of knowledge on the mechanisms of pain onset, Chapter Two provides information on short and long-term factors that clinicians consider important in triggering a back pain episode. The studies described in Chapter Four and Five investigated a range of physical, psychosocial and environmental factors that increase risk for an episode of sudden onset, acute low back pain. Chapter Six presents the current evidence on whether magnetic resonance imaging findings of the lumbar spine predict future back pain. Chapter Seven aimed to examine the prognosis and prognostic factors for patients with chronic back pain. A systematic review investigating if the presence of magnetic resonance imaging findings identifies patients with back pain who respond better to particular interventions is presented in Chapter Eight. Finally, Chapter Nine sought to identify factors that influence recruitment of participants to a large observational study.