The course of acute low back pain: a community-based inception cohort study.

Introduction: Acute low back pain (LBP) is increasingly recognized for its potential recurrent nature and long-term implications.

Objectives: This community-based inception cohort study aimed to delineate trajectories of acute LBP over one year and investigate associated biopsychosocial variables.

Methods: One hundred seventy-six participants with acute LBP were monitored at 5 follow-up time points over 52 weeks. Pain trajectories were identified using a latent class linear mixed model, and their associations with baseline biopsychosocial factors were evaluated through multinomial logistic regression.

Results: Four distinct LBP trajectories were discerned: "mild/moderate fluctuating pain" (54.0%), "delayed recovery by week 52" (6.2%), "persistent moderate pain" (33.0%), and "moderate/severe fluctuating pain" (6.8%). Increased baseline pain intensity and history of LBP episodes were significantly linked with less favorable trajectories. Contrary to expectations, psychological variables like stress, anxiety, and depression did not significantly associate with unfavorable trajectories.

Discussion: This study underscores the heterogeneity of acute LBP's course over a year, challenging the conventionally benign perception of the condition. Recognizing these distinct trajectories might enable more tailored, effective clinical interventions for LBP patients. The small sample size of certain trajectories may influence the generalizability of the results.

Conclusion: Acute LBP can manifest in different trajectories, with nearly half of the participants experiencing less favorable trajectories. Baseline pain intensity and previous episodes of LBP emerged as key factors, whereas psychological variables had no discernible influence. Recognition of these trajectories may be necessary for improved patient management and targeted interventions.