Leena Niemistö ^A1, Seppo Sarna ^A2, Tiina Lahtinen-Suopanki ^A1, Karl-August Lindgren ^A1, Heikki Hurri ^A1
A1 Rehabilitation Unit of Orthopaedic Hospital ORTON, Invalid Foundation, Helsinki, Finland
^A2 Department of Public Health, University of Helsinki, Helsinki, Finland

DOI: 10.1080/16501970310019151

Objectives: To examine the relative influences of sociodemographic and episode-specific factors on change in low back pain intensity and self-rated disability. Methods: Of 204 patients with chronic low back pain, 102 were randomized to a combined manipulation, exercise and physician consultation group and 102 to a consultation-alone group. These groups were each divided into 2 clusters based on change in both pain intensity and self-rated disability at 1 year. The first cluster included patients whose symptoms clearly decreased, and the second those whose trouble persisted. Association between sociodemographic and episode-specific factors and poor recovery from low back pain and disability were evaluated by univariate and multivariate analysis. Results: Severe affective distress (OR 3. 81; 95% CI 1. 3-10. 8) predicted poor response to the manipulative treatment. Over a 25-day sick leave during previous year (19. 64; 3. 8-102. 5), poor life control (9. 40; 1. 9-47. 0), and generalized somatic symptoms (3. 18; 0. 9-11. 6) were the risk factors for not benefiting from the informative approach. Conclusions: Psychosocial differences seem to be important determinants for treatment outcomes, and should be the focus of future studies.