Biopsychosocial predictors of pain, disability, health care consumption, and sick leave in first-episode and long-term back pain: a longitudinal study in the general population

Int J Behav Med. 2010 Jun;17(2):79-89. doi: 10.1007/s12529-009-9055-3.


Background: Long-term outcome in back pain is related mainly to cognitive factors such as pain-related beliefs and expectations. Most research has been performed on patient samples.

Purpose: This study aimed at investigating changes over time in reported back pain, pain intensity, disability, health care consumption, and sick leave as well as biopsychosocial factors over a 12-month period. A second aim was to identify predictors of reported pain, pain intensity, disability, health care consumption, and sick leave.

Method: As parts of a large back pain sample from a general population (n = 1,024), two groups-one with first-episode pain (n = 77) and one with long-term pain (n = 302)-responded twice to a self-administered questionnaire. Among participants reporting pain at both assessments, changes over time were analyzed and predictive models were tested.

Results: Generally, the results demonstrated overall stability in the self-reports over time. However, reported pain decreased in both groups, while pain catastrophizing and pain expectations increased in the first-episode group. Pain intensity and disability were predicted in regression models including four cognitive factors and initially reported levels of pain intensity and disability.

Conclusion: The significance of pain-related beliefs and expectations both in early and later stages of a back pain condition is pointed out. The results in this study based on a sample from the general population are in line with previous research on patient samples.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Back Pain / psychology*
  • Chronic Disease
  • Cognition*
  • Delivery of Health Care / statistics & numerical data*
  • Disability Evaluation*
  • Fear* / psychology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Registries
  • Risk Factors
  • Sampling Studies
  • Severity of Illness Index
  • Sick Leave / statistics & numerical data*
  • Surveys and Questionnaires
  • Time Factors