Mechanical Pain Patterns and Risk Factors Associated with its Chronification among Patients with Non-Specific Low Back Pain at Nakuru Teaching and Referral Hospital

Abstract

The majority of patients with low back pain presents with the non-specific low back pain sub-type, research has shown that most of these patients often do not recover fully and risk transitioning to chronic pain. Causing extraordinary levels of disability, poor health-related quality of life and expensive medical cost due prolonged overutilization of healthcare services. In our setup, there is limited availability of information regarding how to address the aforementioned issue. The aim of this study was to identify the mechanical pain patterns associated with non-specific low back pain and assess the risk factors contributing to its chronification among individuals seeking treatment at the outpatient physiotherapy clinic in a tertiary facility located in Nakuru. Study Site: This study was done at Nakuru Teaching and Referral hospital in Nakuru County. Study design; An analytical cross-sectional; sample size of 70 participants were selected from physiotherapy out -patient department clinic. Methods; Participants were categorized into four Mechanical Pain Pattern (P1, P2, P3 &P4) through Saskatchewan Spine Pathway Assessment and Referral form and level of chronicity was established using Orebro Musculoskeletal pain screening questionnaire (OMPSQ). Descriptive and inferential statistics was generated using SPSS version26.Results; Among the participants Pattern1(n=32:45.7%, Pattern 2(n=11:15.7%), Pattern 3(n=15;21.5%) and Pattern 4(n=12;17.1%) were identified. The majority of participants were categorized as follows: 37.1% at moderate risk, 17.2% at high risk, and 45.7% at low risk. Concerning risk of chronification, Pain location was significantly correlated with Pattern 3 (p<0.012), whilst absenteeism was significant with leg symptoms(p<0.020) and severe disability index index/severe disability index (p<0.046) demonstrated a significant association. Absenteeism was found to be significant correlated with pain duration. Physical activity makes pain worse was positive correlated with extent of depression, risk of persistence and pain episodes. Significant predictors for risk of chronification were level of education, Pattern 3, and Pattern 4.Conclusion; this study established majority of patients of NSLBP categorized as P1 and 54%were flagged as moderate risk to high risk for chronification. Furthermore, those with subtype P3 mechanical pain pattern, leg symptoms, severe disability index; these clinical characteristics were associated with risk of chronification. That Orebro-musculoskeletal may implemented to identify patients at of risk of chronification.