The association between a lifetime history of low back injury in a motor vehicle collision and future low back pain: a population-based cohort study

Paul S. Nolet*, Vicki L. Kristman, Pierre Côté, Linda J. Carroll, J. David Cassidy

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Purpose: This population-based cohort study investigated the association between a lifetime history of a low back injury in a motor vehicle collision (MVC) and future troublesome low back pain. Participants with a history of a low back injury in a motor vehicle collision who had recovered (no or mild low back pain) were compared to those without a history of injury. Current evidence from two cross-sectional and one prospective study suggests that individuals with a history of a low back injury in a MVC are more likely to experience future LBP. There is a need to test this association prospectively in population-based cohorts with adequate control of known confounders. Methods: We formed a cohort of 789 randomly sampled Saskatchewan adults with no or mild LBP. At baseline, participants were asked if they had ever injured their low back in a MVC. Six and 12 months later, participants were asked about the presence of troublesome LBP (grade II–IV) on the Chronic Pain Grade Questionnaire. Multivariable Cox proportional hazards regression analysis was used to estimate the association while controlling for known confounders. Results: The follow-up rate was 74.8% (590/789) at 6 months and 64.5% (509/789) at 12 months. There was a positive crude association between a history of low back injury in a MVC and the development of troublesome LBP over a 12-month period (HRR = 2.76; 95% CI 1.42–5.39). Controlling for arthritis reduced this association (HRR = 2.25; 95% CI 1.11–4.56). Adding confounders that may be on the casual pathway (baseline LBP, depression and HRQoL) to the multivariable model further reduced the association (HRR = 2.20; 95% CI 1.04–4.68). Conclusion: Our analysis suggests that a history of low back injury in a MVC is a risk factor for developing future troublesome LBP. The consequences of a low back injury in a MVC can predispose individuals to experience recurrent episodes of low back pain.

Original languageEnglish
JournalEuropean Spine Journal
Volume27
Issue number1
Pages (from-to)136-144
ISSN0940-6719
DOIs
Publication statusPublished - Jan 2018

Keywords

  • Cohort studies
  • Low back pain
  • Risk factors
  • Traffic accidents
  • Whiplash injuries
  • Accidents, Traffic/statistics & numerical data
  • Prospective Studies
  • Cross-Sectional Studies
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Risk Factors
  • Male
  • Saskatchewan
  • Low Back Pain/epidemiology
  • Back Injuries/complications
  • Adult
  • Female
  • Surveys and Questionnaires
  • Cohort Studies

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