Does anterior trunk pain predict a different course of recovery in chronic low back pain

Patient characteristics related to the course and severity of low back pain (LBP) and disability have been the focus of extensive research, however, known characteristics do not explain much of the variation in outcomes. The relationship between anterior trunk pain (ATP) and LBP has not been explored, though mechanisms for visceral referred pain have been described. The study’s aims were: (1) determine frequency of ATP in chronic LBP patients, (2) determine whether there is an association between ATP and increased pain and disability in these patients, and (3) evaluate whether ATP predicts the course of pain and disability in these patients. In this study, spinal outpatient department patients mapped the distribution of their pain and patients describing pain in their chest, abdomen or groin were classified with ATP. Generalized estimating equations were performed to examine the relationship between ATP and LBP outcomes. A total of 2974 patients were included and 19.6% of patients reported ATP. At all time points, there were significant differences in absolute pain intensity and disability in those with ATP compared with those without. The presence of ATP did not affect the clinical course of LBP outcomes.

This study’s results indicate that patients who present with LBP and ATP have higher pain and disability levels than patients with localised LBP. Visceral referred pain mechanisms could help to explain some of this difference.