Risk factors for non-specific low back pain in schoolchildren and their parents: a population based study

A survey of adolescent schoolchildren and their parents through a self-administered questionnaire was conducted to determine the prevalence of low back pain (LBP) in schoolchildren and their parents and to assess its association with exposure to known and presumed risk factors. A previously validated, self-administered questionnaire was used for collecting information on back pain history, anthropometric measures, physical and sports activity, academic problems, hours of leisure sitting, smoking, and alcohol intake. Schoolchildren between the ages of 13 and 15 in schools of the island of Mallorca and their parents (n=16,394) took part in the study. The lifetime prevalence of LBP was 50.9% for boys and 69.3% for girls; point prevalence (7 days) was 17.1% for boys and 33% for girls. There was a significant association with LBP and pain in bed (OR=13.82, 95% CI: 10.47-18.25, P<0.001), reporting scoliosis (OR=2.87, 95% CI: 2.45-3.37, P<0.001), reporting difference in leg length (OR=1.26, 95% CI: 1.02-1.56, P=0.033), practice of any sport more than twice a week (OR=1.23, 95% CI: 1.09-1.39, P=0.001) and being female (OR=1.11, 95% CI: 1.04-1.19, P=0.001). There was no association found between LBP and body mass index, the manner in which books were transported, hours of leisure sitting, alcohol intake or cigarette smoking. Among parents, the lifetime prevalence of LBP was 78.2% for mothers and 62.6% for fathers; point prevalence (7 days) was 41% for mothers and 24.3% for fathers, and there were significant associations with LBP and pain in bed (OR=18.07, 95% CI: 14.72-22.19, P<0.001), report of scoliosis (OR=8.77, 95% CI: 6.44-11.95, P<0.001), report of difference in leg length (OR=2.21, 95% CI: 1.60-3.04, P<0.001), being a university graduate (OR=1.89, 95% CI: 1.21-2.98, P=0.006), being female (OR=1.49, 95% CI: 1.33-1.67, P<0.001), and swimming (OR=1.10, 95% CI: 1.4-1.18, P=0.002). There was no association found between LBP and alcohol intake, cigarette smoking or the practice of other sports. Although there was a positive association in terms of scoliosis between biological parents and their children (P<0.001), there was no association found in familial (biological or not) occurrence of LBP. The prevalence of LBP among adolescents in southern Europe is similar to northern Europe, it is comparable to that in adults, and is associated with several factors. There is a strong association between pain in bed or upon rising in both adolescents and adults. Scoliosis, but not LBP, appears to be related to heredity. Further longitudinal studies are necessary to establish risk factors that are predictive for LBP in adolescents.     

Low back pain may be caused by disturbed pain regulation

Background: Widespread pain has negative influence on outcome in low back pain (LBP) patients. Tender point (TP) examination is a standardized examination method to estimate diffuse tenderness. Aims: To assess diffuse tenderness by means of a standardized TP examination and to analyse for associations between the number of TPs and spinal structural changes as well as psycho‐social factors. Methods: Patients sick‐listed 3–16 weeks due to LBP with or without sciatica completed a questionnaire and went through a clinical low back examination and TP examination. Of 326 patients 111 had verified nerve root affection and 215 had non‐specific LBP with or without radiating pain. Disc height reductions were estimated on lateral X‐rays. Results: Multivariate logistic regression analysis showed that more than 8 TPs were strongly negatively associated with disc degeneration (Odds Ratio (OR) 0.58 (0.40–84), 95% Confidence Interval (CI): 0.39–0.84, p = 0.004) and verified nerve root affection (OR 0.15 (0.04–0.54), p = 0.004) and were positively associated with number of years since first episode of LBP (OR 1.05, CI: 1.01–1.09, p = 0.009). Furthermore, more than 8 TPs were positively associated with widespread pain, female sex and bodily distress. With all patients included, bodily distress and the number of tender points were positively associated with the intensity of LBP, but disc degeneration was only positively associated with LBP in patients with less than 6 TPs. Conclusions: The pain in patients with diffuse tenderness was rarely related to disc degeneration or nerve root affection, rather it may be caused by disturbed pain regulation.     

The prevalence and management of low back pain across adulthood: results from a population-based cross-sectional study (the MUSICIAN study)

The aim of the current study was to determine: the prevalence of low back pain (LBP) and associated disability; the frequency of consultation to general practice; whether there were differences in management by age. We conducted a cross-sectional population study in Aberdeen city and Cheshire County, UK. Participants were 15,272 persons aged 25 years and older. The 1-month period prevalence of LBP was 28.5%. It peaked at age 41-50 years, but at ages over 80 years was reported by 1 in 4 persons. Older persons were more likely to consult, and the prevalence of severe LBP continued to increase with age. Management by general practitioners differed by age of the patient. Older persons (> 70 vs ≤ 40 years) were more likely to only have been prescribed painkillers (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.28-2.35) or only pain killers with other medications (OR 1.45, 95% CI 1.07-1.98). They were less likely to be prescribed physiotherapy or exercise (OR 0.63, 95% CI 0.46-0.85) or to be referred to a specialist (OR 0.77, 95% CI 0.57-1.04). Older persons were more likely to have previously received exercise therapy for pain, were less likely to be enthusiastic about receiving it now (P<0.0001), and were less likely to think it would result in improved symptoms (P<0.0001). It is important that older persons, who have the highest prevalence of LBP with disability and are most likely to consult, are receiving optimal pharmacological and nonpharmacological management.     

The prevalence of knee pain and symptomatic knee osteoarthritis among veteran traumatic amputees and nonamputees

OBJECTIVE: To determine whether amputees have an increased risk of knee pain or symptomatic osteoarthritis (OA) compared with nonamputees. DESIGN: Retrospective cohort study. SETTING: Veterans Administration Patient Treatment and Outpatient Care files. PARTICIPANTS: All male unilateral (transtibial or transfemoral) traumatic amputee patients and a random sample of male nonamputees. Patients were excluded if they were younger than 40 years, had sustained a significant injury to their knee(s), or had a rheumatic disease. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The prevalence of knee pain and symptomatic knee OA. RESULTS: The age and average weight-adjusted prevalence ratio of knee pain among transtibial amputees, compared with nonamputees, was 1.3 (95% confidence interval [CI], 0.7-2.1) for the knee of the intact limb and 0.2 (95% CI, .05-0.7) for the knee of the amputated limb. The standardized prevalence ratio of knee pain in the intact limb and symptomatic OA among transfemoral amputees, compared with nonamputees, was 3.3 (95% CI, 1.5-6.3) and 1.3 (95% CI, 0.2-4.8), respectively. CONCLUSIONS: Stresses on the contralateral knee of amputees may contribute to secondary disability. Possible explanations include gait abnormalities, increased physiologic loads on the knee of the intact limb, and the hopping and stumbling behavior common in many younger amputees.     

Choice of treatment modalities was not influenced by pain,severity or co‐morbidity in patients with knee osteoarthritis

Background and Purpose. Patients with knee osteoarthritis (OA) are commonly treated by physiotherapists in primary care. The physiotherapists use different treatment modalities. In a previous study, we identified variation in the use of transcutaneous electrical nerve stimulation (TENS), low level laser or acupuncture, massage and weight reduction advice for patients with knee OA. The purpose of this study was to examine factors that might explain variation in treatment modalities for patients with knee OA. Methods. Practising physiotherapists prospectively collected data for one patient with knee osteoarthritis each through 12 treatment sessions.We chose to examine factors that might explain variation in the choice of treatment modalities supported by high or moderate quality evidence, and modalities which were frequently used but which were not supported by evidence from systematic reviews. Experienced clinicians proposed factors that they thought might explain the variation in the choice of these specific treatments. We used these factors in explanatory analyses. Results. Using TENS, low level laser or acupuncture was significantly associated with having searched databases to help answer clinical questions in the last six months (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.08–3.42). Not having Internet access at work and using more than four treatment modalities were significant determinants for giving massage (OR = 0.36, 95% CI = 0.19–0.68 and OR = 8.92, 95% CI = 4.37–18.21, respectively). Being a female therapist significantly increased the odds for providing weight reduction advice (OR = 3.60, 95% CI = 1.12–11.57). No patient characteristics, such as age, pain or co‐morbidity, were significantly associated with variation in practice. Conclusions. Factors related to patient characteristics, such as pain severity and co‐morbidity, did not seem to explain variation in treatment modalities for patients with knee OA. Variation was associated with the following factors: physiotherapists having Internet access at work, physiotherapists having searched databases for the last six months and the gender of the therapist. There is a need for more studies of determinants for physiotherapy practice. Copyright © 2009 John Wiley & Sons, Ltd.     

Perceived pain and satisfaction with medical rehabilitation after hospital discharge

OBJECTIVE: To examine the association between pain and satisfaction with medical rehabilitation in patients with hip or knee replacement approximately 90 days after discharge from inpatient medical rehabilitation. DESIGN: A cross-sectional design. PARTICIPANTS: The sample included 2507 patients with hip or knee replacement using information from the IT Health Track medical outcome database. MAIN OUTCOME MEASURE: Satisfaction with medical rehabilitation. RESULTS: The average age was 70.2 years, 66.5% were female, and 88.5% were non-Hispanic white. Pain scores were significantly and inversely associated with satisfaction with medical rehabilitation after adjustment for possible confounding factors. In patients with hip replacement each one-point increase in pain score was associated with a 10% decreased odds ratio (OR) of being satisfied with medical rehabilitation (OR 0.90, 95% confidence interval (CI) 0.84, 0.96). In patients with knee replacement, each one-point increase in pain score was associated with a 9% decreased odds ratio (OR 0.91, 95% CI 0.87, 0.96) of being satisfied with medical rehabilitation. CONCLUSION: Our data indicate that postoperative pain from hip or knee replacement is associated with reduced satisfaction with medical rehabilitation. Better postoperative pain control may improve a patient's level of satisfaction.     

Colon diverticula: origin, prevalence, clinical manifestations

AIM: To study prevalence of colon diverticula (CD) and phenotypical features of patients with this anomaly. MATERIAL AND METHODS: At the first stage of the study we analysed colon x-ray evidence for 3 years to assess prevalence of CD. At the second stage we examined 59 patients with CD. Sixty patients with idiopathic constipation and 48 patients with irritable colon syndrome served control. RESULTS: We discovered the following independent factors associated with a high CD risk: history of CD in the relatives of the patients (OR 24.6; 95% CI 5.23-116.23; p = 0.0001) and age of the patient (OR 2.5; 95% CI 1.03-1.13; p = 0.0010). Age-dependent CD occurrence, similar anomalies in the relatives, other structural gastrointestinal anomalies in them, hyperaminociduria suggest that CD represent a metabolic involutionary process with hereditary predisposition. CD manifested clinically with abdominal pain and problems with colon passage. Abdominal pain related to defecation occurred with low pain threshold to extension. Abdominal pain risk in CD patients is significantly associated with intestinal infections (OR 4.56; 95% CI 1.09-18.97; chi-square = 4.34; p = 0.0372) and connective tissue dysplasia syndrome (OR 2.21; 95% CI 1.23-3.95; chi-square = 7.08; p = 0.0078). Independent risk factors of constipation in CD are non-morning defecation (OR 8.68; 95% CI 1.55-48.51; chi-square = 6.06; p = 0.0138), connective tissue dysplasia syndrome (OR 1.77; 95% CI 1.0-3.20; chisquare = 3.65; p = 0.0501), sedentary life style (OR 7.42; 94% CI 1.24 - 44.57; chi-square = 4.81; p = 0.0284). CONCLUSION: Incomplete CD reflect colon involution. Abdominal pain associated with defecation has much in common with irritable colon syndrome.     

Effect of Comorbid Knee and Hip Osteoarthritis on Longitudinal Clinical and Health Care Use Outcomes in Older Adults With New Visits for Back Pain

Objective

To examine if a comorbid diagnosis of knee or hip osteoarthritis (OA) in older adults with new back pain visits is associated with long-term patient-reported outcomes and back-related health care use.

Muscle tenderness in different types of facial pain and its relation to anxiety and depression: A cross-sectional study on 649 patients

To evaluate in patients with different types of facial pain the association between muscle tenderness and a set of characteristics, 649 consecutive outpatients with facial myogenous pain (MP), TMJ disorder, neuropathic pain (NP) and facial pain disorder (FPD) (DSM-IV) were enrolled. For each patient a psychological assessment on the Axis 1 of the DSM-IV and standardized palpation of pericranial and cervical muscles were carried out. A pericranial muscle tenderness score (PTS), a cervical muscle tenderness score (CTS) and a cumulative tenderness score (CUM, range 0-6) were calculated. Univariate analyses (one-way analysis of variance or chi(2) test) indicated that both age- and sex-distribution, tenderness scores and prevalence of psychiatric disorders markedly differed between groups. The prevalence of depression was highest in FPD patients (44.9%). Both muscle tenderness scores (either PTS or CTS) and prevalence of anxiety were higher in patients with MP than in those with TMJ or NP. To assess associations between CUM score and patients' demographic and clinical characteristics an ordered logit model was fit and interactions between psychiatric disorders and diagnostic groups were tested. The analysis showed that, regardless of the diagnostic group, anxiety and depression independently increase the likelihood of having one point higher muscle tenderness score (OR=1.55, 95% CI: 1.13-2.12 and OR=1.56, 95% CI: 1.10-2.21, respectively). A careful screening for the presence of an underlying psychiatric disorder, either anxiety or depression, should be part of the clinical evaluation in patients suffering from facial pain.     

Association between sitting time and orthopedic conditions in Korean older adults

This study aimed to identify the association between sitting time and orthopedic conditions in Korean older adults. Data from adults aged ≥65 years from the 6th Korea National Health and Nutrition Examination Survey (2014–2015) were used for analysis (n = 3,011). Sitting time ≥7.5 h/day was significantly associated with knee joint (OR = 1.41, 95% CI: 1.11, 1.79), hip joint (OR = 1.54, 95% CI: 1.17, 2.03), and low back pain (OR = 1.44, 95% CI: 1.19, 1.74) when adjusted for sex, age, obesity, housing type, family income, education, and marital status in multiple logistic regression analyses. These findings imply that appropriate pain management according to sociodemographic characteristics in orthopedic conditions are necessary to reduce excessive sitting time in Korean older adults.     

Does adding hip strengthening exercises to manual therapy and segmental stabilization improve outcomes in patients with nonspecific low back pain? A randomized controlled trial

BackgroundThe literature is unclear on the need for hip strengthening in persons with low back pain (LBP).ObjectivesTo investigate the effectiveness of hip strengthening exercises when added to manual therapy and lumbar segmental stabilization in patients with chronic nonspecific LBP.MethodsSeventy patients with chronic nonspecific LBP were randomly assigned to either the manual therapy and lumbar segmental stabilization group or the manual therapy and lumbar segmental stabilization plus specific hip strengthening group. A 10 cm visual analogue scale and the Rolland-Morris Questionnaire were the primary clinical outcome measures at baseline, at the end of treatment (posttreatment), and 6- and 12-months posttreatment. Hip strength and kinematics were measured as secondary outcomes .ResultsWhile within-group improvements in pain, disability, and hip extensors strength occurred in both groups, there were no significant between-group differences at posttreatment or follow-ups. Mean difference in changes in pain level between groups at posttreatment and at 6- and 12-month follow-up were 0.5 points (95% confidence interval [CI]: -0.5, 1.5), 0.3 points (95% CI: -0.9, 1.5), and 0.0 points (95% CI: -1.1, 1.1), respectively. The mean differences in changes in disability were 0.8 points (95% CI: -1.3, 2.7), 0.0 points (95% CI: -2.4, 2.4), and 0.4 points (95% CI: -2.0, 2.8), respectively. Finally, we did not observe any between-group differences for any of the other outcomes at any timepoint.ConclusionThe addition of specific hip strengthening does not appear to result in improved clinical outcomes for patients with nonspecific LBP.     

Fear-avoidance beliefs and pain coping strategies in relation to lower back problems in a South African steel industry.

The objective was to determine the association between the prevalence of lower back problems (LBP), fear-avoidance beliefs and pain coping strategies using an analytical cross-sectional epidemiological study among a group of 366 workers in a South African stainless steel industry. Outcome (LBP) was defined using a questionnaire and a functional rating index. Exposure to psychosocial risk was determined using the Fear-Avoidance Beliefs (FABQ) and Coping Strategies (CSQ) questionnaires. Multivariate logistic regression analyses for LBP indicated the following significant risk factors: work-related fear-avoidance beliefs (OR 3.40; 95% CI 2.20-5.25), catastrophizing (1.31; 1.01-1.7) and pain coping self statements (1.47; 1.16-1.87). Significant protective associations were found for increased activity levels (OR 0.57; 95% CI 0.42-0.78). These findings have utility in preventative screening procedures to identify workers with such beliefs and coping strategies who are at risk for prolonged work restrictions.     

Relationship Between the Exposure to Occupation-related Psychosocial and Physical Exertion and Upper Body Musculoskeletal Diseases in Hospital Nurses: A Systematic Review and Meta-analysis

PurposeNurses’ musculoskeletal diseases (MSDs) are worldwide prevalent and are considered to be a costly occupational injury. This study aims to investigate the relationship between exposure to occupation-related psychosocial factors, physical workload, and upper body musculoskeletal diseases among hospital nurses.MethodsAn electronic search was implemented using nine databases with June 2019 as the latest search date. English and Chinese studies were chosen, and data were independently and separately extracted by two investigators. Pooled odds ratio (OR) and its 95% confidence interval (CI) were estimated for each subset, using the fixed or random-effects model, following heterogeneity between studies for research synthesis. The source of heterogeneity was explored through subgroup, sensitivity, and meta-analyses.ResultsEighteen studies were included in the meta-analysis. Most participants were women (51.4%–100.0%), aged between 20 and 60. A correlation was found between high job demand and the prevalence of low back pain (OR = 1.41; 95% CI = 1.23-1.62). Total job strain was related to the risk of low back pain (OR = 1.71; 95% CI = 1.15-2.55), neck pain (OR = 1.67; 95% CI = 1.26-2.20), shoulder pain (OR = 1.62; 95% CI = 1.06-2.48) and back pain (OR = 1.45; 95% CI = 1.10-1.91). Furthermore, the physical workload was significantly associated with the prevalence of low back pain (OR = 1.76; 95% CI = 1.32-2.35), neck pain (OR = 1.17; 95% CI = 1.08-1.27), shoulder pain (OR = 1.59; 95% CI = 1.37-1.85) and back pain (OR = 1.66; 95% CI = 1.45-1.90).ConclusionThere were significant associations between occupational strain, more physical workload and upper body MSDs, but the evidence advocating a growth risk in MSDs due to low levels of social support is quite weak.     

The prevalence and risk factors of falling and fear of falling among lower extremity amputees

OBJECTIVE: To estimate the falling experience and fear of falling status and to describe characteristics associated with falling and fear of falling. DESIGN: Population-based consecutive sample survey and chart review. SETTING: Two Canadian, regional, university-affiliated outpatient amputee clinics. PARTICIPANTS: The sample (n = 435; mean age, 62 +/- 15.7 yr) of community-living participants was mostly male (71%), had unilateral (below knee 73%; above knee 27%) amputations primarily for vascular (53% vs 47% nonvascular) reasons. INTERVENTION: Review patient charts and survey questionnaires to determine sociodemographic information (eg, social support), information about the amputation (eg, cause, level, problems), physical health and function (eg, pain, limitations, comorbidity), and psychologic state (depression, adaptation). MAIN OUTCOME MEASURES: Occurrence of a fall in the past 12 months and presence of a fear of falling. RESULTS: Exactly 52.4% subjects reported falling in the past year, whereas 49.2% reported a fear of falling. Logistic regression analyses revealed falling was related to having an above knee amputation (odds ratio [OR] = 2.78; 95% confidence interval [CI] = 1.71-4.51), back (OR = 1.96; 95% CI = 1.08-3.54) and joint (OR = 1.67; 95% CI = 1.01-2.74) pain, and multiple stump and prosthesis problems (OR = 3.09; 95% CI = 1.58-6.04). Having had the amputation > or = 4 years in the past was protective (OR =.53; 95% CI =.29-.89). Factors related to an increase risk of fear of falling included having to concentrate on each step while walking (OR = 4.06; 95% CI = 2.46-6.71) and having a fall in the past 12 months (OR = 1.62; 95% CI = 1.04-2.54), whereas being male (OR = 0.35; 95% CI =.21-.57) and having good to excellent perceived health (OR =.35; 95% CI =.21-.58) were protective. CONCLUSIONS: Falling and fear of falling are pervasive among amputees. Comprehensive and ongoing intervention and education should be considered. Research is required to assess the consequences of falling and fear of falling.     

Obesity and risk of venous thromboembolism among postmenopausal women: differential impact of hormone therapy by route of estrogen administration. The ESTHER Study

BACKGROUND: Oral estrogen use and elevated body mass index (BMI) increase the risk of venous thromboembolism (VTE). Recent data suggest that transdermal estrogen might be safe with respect to thrombotic risk. However, the impact of transdermal estrogen on the association between overweight (25 kg m(-2) < BMI < or = 30 kg m(-2)) or obesity (BMI >30 kg m(-2)) and VTE risk has not been investigated. METHODS: We carried a multicenter case-control study of VTE among postmenopausal women aged 45-70 years, between 1999 and 2005, in France. Case population consisted of women with a first documented idiopathic VTE. We recruited 191 hospital cases matched with 416 hospital controls and 62 outpatient cases matched with 181 community controls. RESULTS: The odds ratio (OR) for VTE was 2.5 [95% confidence interval (CI):1.7-3.7] for overweight and 3.9 (95% CI: 2.2-6.9) for obesity. Oral, not transdermal, estrogen was associated with an increased VTE risk (OR = 4.5; 95% CI: 2.6-7.7 and OR = 1.1; 95% CI: 0.7-1.7, respectively). Compared with non-users with normal weight, the combination of oral estrogen use and overweight or obesity further enhanced VTE risk (OR = 10.2; 95% CI: 3.5-30.2 and OR = 20.6; 95% CI: 4.8-88.1, respectively). However, transdermal users with increased BMI had similar risk as non-users with increased BMI (OR = 2.9; 95% CI: 1.5-5.8 and OR = 2.7; 95% CI: 1.7-4.5 respectively for overweight; OR = 5.4; 95% CI: 2.1-14.1 and OR = 4.0; 95% CI: 2.1-7.8 respectively for obesity). CONCLUSIONS: In contrast to oral estrogen, transdermal estrogen does not confer an additional risk of idiopathic VTE in women with increased BMI. The safety of transdermal estrogen on thrombotic risk has to be confirmed.     

Characteristics Associated With People With Chronic Low Back Pain Meeting Physical Activity Guidelines and Recommendations for Sedentary Behavior: A Cross-Sectional Study

ObjectiveThe purpose of this study was to identify factors associated with meeting physical activity guidelines and sedentary recommendations in people with chronic low back pain (LBP).MethodsThis was a cross-sectional study including 171 people with chronic LBP. Trained assessors collected information regarding demographic, anthropometric, and clinical data. Physical activity levels and sedentary time were objectively measured using a tri-axial accelerometer. Participants were classified as being physically active (ie, performing at least 150 minutes of moderate or 75 minutes of vigorous physical activity per week) and sedentary (ie, more than 8 hours of time spent in sedentary activities per day). Multivariable logistic regression analyses were used to determine the association of being physically active or sedentary with the range of demographic, anthropometric and clinical variables.ResultsOur results showed that although lower body mass index (odds ratio [OR] = 0.91; 95% CI: 0.85-0.98) and higher self-reported levels of leisure time physical activity (OR = 3.46; 95% CI: 1.94-6.15) were associated with being physically active, lower self-reported levels of physical activity at work (OR = 0.56; 95% CI: 0.39-0.81) was associated with being sedentary.ConclusionOur findings showed that, in people with LBP, lower body mass index and higher levels of leisure time physical activity may be important factors for identifying those physically active. In contrast, lower levels of physical activity at work may be considered when identifying sedentary people with LBP. Future studies should consider these factors when designing interventions aiming to promote physical activity and decrease sedentary behavior in this population.     

Development of and recovery from short- and long-term low back pain in occupational settings: A prospective cohort study

Using the data of the EuroBack Unit prospective cohort study, this paper investigated the role of work-related physical factors and psychological variables in predicting the development of and recovery from short-term and long-term LBP. At baseline, 1294 predominantly male industrial workers from 10 companies in Belgium and the Netherlands filled in questionnaires. At follow-up, data from 812 employees were available. Odds ratios (ORs) were calculated using simple and multiple logistic regression analyses. For those workers reporting 0 days LBP in the year prior to baseline, negative affectivity (OR 1.06, 95% CI 1.01-1.11) was a risk factor for the development of short-term LBP (=1-30 days total of LBP in the year prior to follow-up). For those who reported 1-30 days total of LBP in the year prior to baseline, only high fear of (re)injury due to movement (OR 1.07, 95% CI 1.02-1.12) increased the risk for failure to recovery from short-term LBP. For the development of long-term LBP (=more than 30 days total of LBP in the year prior to follow-up), a significant increased risk was observed among workers with high pain severity (OR 1.19, 95% CI 1.01-1.40) and with pain referred to the ankles or feet (OR 2.92, 95% CI 1.09-7.83). The risk was reduced by social support of co-workers (OR 0.73, 95% CI 0.59-0.92) and by manual handling of materials (OR 0.63, 95% CI 0.46-0.85). For those who reported more than 30 days total of LBP in the year prior to baseline, high pain severity (OR 1.18, 95% CI 1.04-1.34) increased the risk for failure to recovery from long-term LBP. Results are compared to the baseline study (Gheldof et al., 2005) and discussed in relation with prospective studies.