Comparison of pain-resilient working individuals to population-based case controls with/without momentary low back pain

Rolli Salathé, C.; Melloh, M.; Kälin, W.; Semmer, N. K.; Roth, M.; Müller, U.; Elfering, A. (2013). Comparison of pain-resilient working individuals to population-based case controls with/without momentary low back pain. European journal of pain, 17(9), pp. 1411-1421. Wiley-Blackwell 10.1002/j.1532-2149.2013.00319.x

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Background: Few studies have examined the 20% of individuals who
never experience an episode of low back pain (LBP). To date, no
investigation has been undertaken that examines a group who claim to
have never experienced LBP in their lifetime in comparison to two
population-based case–control groups with and without momentary LBP.
This study investigates whether LBP-resilient workers between 50 and 65
years had better general health, demonstrated more positive health
behaviour and were better able to achieve routine activities compared with
both case–control groups.
Methods: Forty-two LBP-resilient participants completed the same pain
assessment questionnaire as a population-based LBP sample from a
nationwide, large-scale cross-sectional survey in Switzerland. The
LBP-resilient participants were pairwise compared to the propensity
score-matched case controls by exploring differences in demographic and
work characteristics, and by calculating odds ratios (ORs) and effect sizes.
A discriminant analysis explored group differences, while the multiple
logistic regression analysis specified single indicators which accounted for
group differences.
Results: LBP-resilient participants were healthier than the case controls
with momentary LBP and achieved routine activities more easily.
Compared to controls without momentary LBP, LBP-resilient participants
had a higher vitality, a lower workload, a healthier attitude towards health
and behaved more healthily by drinking less alcohol.
Conclusions: By demonstrating a difference between LBP-resilient
participants and controls without momentary LBP, the question that arises
is what additional knowledge can be attained. Three underlying traits seem
to be relevant about LBP-resilient participants: personality, favourable
work conditions and subjective attitudes/attributions towards health.
These rationales have to be considered with respect to LBP prevention.

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