Journal of Preventive Medicine and Public Health

Original Articles

Prognostic Scoring Model for the Transition From Acute to Chronic Non-specific Low Back Pain in Primary Health Care Units in Indonesia: Djoko Kuswanto, Riva Satya Radiansyah, Dwinka Syafira Eljatin, Muhammad Nazhif Haykal, Rumman Karimah, Ratri Dwi Indriani, Zain Budi Syulthoni, Erna Furaidah, Andiva Satrio Rinaldi, Hafira Nushifa Putri, Jessica Felina Adi, Anak Agung Bagus Wirayuda; J Prev Med Public Health. 2025;58(4):422-430. Published online April 12, 2025; DOI: https://doi.org/10.3961/jpmph.24.581

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Abstract Summary PDF Supplementary Material

Objectives
Non-specific low back pain (NSLBP) is a prevalent health issue that can progress from acute to chronic, resulting in prolonged disability and diminished quality of life. This study aimed to develop a prognostic scoring model to predict the transition from acute to chronic NSLBP in primary care settings.
Methods
This prospective cohort study enrolled 112 adults with acute NSLBP from primary health care units in Indonesia. Participants were assessed at baseline and at a 3-month follow-up visit. Bivariate and multivariable analyses were conducted to identify significant predictors of chronicity. A scoring system was then developed based on the final logistic regression model.
Results
Three factors were found to be significant predictors of the transition to chronic NSLBP: age above 30 years, low education level, and moderate to severe pain intensity. The prognostic scoring model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.705, 70.8% sensitivity, and 62.5% specificity at the optimal cut-off score of 2.5.
Conclusions
This simple prognostic scoring model can help clinicians identify patients at high-risk of developing chronic NSLBP. Early identification of at-risk patients could guide targeted interventions to prevent chronicity. Further validation in diverse populations is necessary to confirm the broader applicability of this model.

Summary

Key Message
This prospective cohort study developed a prognostic scoring model to predict the transition from acute to chronic non-specific low back pain (NSLBP) in primary care settings in Indonesia. The study identified three significant predictors: age above 30 years, low education level, and moderate to severe pain intensity, which formed a simple scoring system with good discrimination ability (AUC = 0.705, sensitivity 70.8%, specificity 62.5%). This practical tool enables clinicians to identify high-risk patients early and implement targeted interventions to prevent chronicity in primary healthcare settings.

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The Role of Dexketoprofen/Tramadol in Multimodal Therapy to Prevent Acute Postsurgical and Acute Low Back Pain from Developing into Chronic Pain: A Delphi Consensus Study
Giustino Varrassi, Maria Dolma Gudez-Santos, Magdi Hanna, Magdalena Kocot-Kępska, Antonio Montero Matamala, Marco Antonio Narvaez Tamayo, Serge Perrot, Jose Luis Aguilar, Omar Al Hamad, Lu’i Al-Husinat, Raad Al-Khafaji, Abdallah Allam, Ezio Amorizzo, Nadi
Pain and Therapy.2026; 15(1): 175. CrossRef

Individual and Occupational Factors Associated With Low Back Pain: The First-ever Occupational Health Study Among Bangladeshi Online Professionals: Mosharop Hossian, Mohammad Hayatun Nabi, Ahmed Hossain, Mohammad Delwer Hossain Hawlader, Nadira Sultana Kakoly; J Prev Med Public Health. 2022;55(1):98-105. Published online January 12, 2022; DOI: https://doi.org/10.3961/jpmph.21.565

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Abstract PDF

Objectives
Low back pain (LBP) is a common chronic condition among sedentary workers that causes long-term productivity loss. This study aimed to identify the relationships of individual and occupational factors with LBP among Bangladeshi online professionals.
Methods
We conducted a cross-sectional study involving 468 full-time online professionals who usually worked in a sitting position. One-month LBP complaints were assessed using a musculoskeletal subscale of subjective health complaints. The chi-square test was used to measure associations between categorical predictors and LBP, and multivariable logistic regression was conducted to identify the variables significantly associated with LBP.
Results
LBP within the last month was reported by 65.6% of participants. Multivariable logistic regression analysis indicated that age >30 years (adjusted odds ratio [aOR], 0.40; 95% confidence interval [CI], 0.23 to 0.70) and being married (aOR, 0.59; 95% CI, 0.36 to 0.97) had significant negative associations with LBP. Significant positive associations were found for spending >50 hours weekly on average working in a sitting position (aOR, 1.61; 95% CI, 1.05 to 2.49), being overweight and obese (aOR, 1.87; 95% CI, 1.16 to 2.99), sleeping on a soft mattress (aOR, 2.01; 95% CI, 1.06 to 3.80), and ex-smoking status (aOR, 3.33; 95% CI, 1.41 to 7.87).
Conclusions
A high prevalence of LBP was found among full-time online professionals. Long working hours in a sitting position showed a significant association with developing LBP. Smoking history, body mass index, and sleeping arrangements should also be considered while considering solutions for LBP prevalence among online professionals.

Summary

Citations

Citations to this article as recorded by

Low back pain and sitting time, posture and behavior in office workers: A scoping review
Nuray Alaca, Ali Ömer Acar, Sergen Öztürk
Journal of Back and Musculoskeletal Rehabilitation.2025; 38(5): 919. CrossRef
Effects of mattress firmness and usage duration on low back pain: a hospital-based study from Lahore
Alveena Mobeen, Hafiz Muhammad Kazim, Nimra Ijaz
Journal of Social & Health Sciences.2024; 2: 34. CrossRef
Pay-for-performance and low back pain with interaction of overwork: findings from the cross-sectional Korean working conditions survey
Julia D. Hur, Jongin Lee
Frontiers in Public Health.2024;[Epub] CrossRef

A Study on the Medical Insurance Utilization of Workers Suffering from Low Back Pain in an Area.: Chul Gab Lee, Hyun Ok Ahn, So Yeon Ryu, Jong Park, Ki Soon Kim, Yang Ok Kim; Korean J Prev Med. 1997;30(4):764-778.

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Abstract PDF: To find the medical insurance utilization of workers when suffering from low back pain, an analysis was made toward the data of medical insurance benefits matched with the general characteristics of 10,183 workers, who were registered continuously from 1993 to 1995 at a medical insurance cooperation for industrial workers. The results were as follows; 1. The period prevalence of the medical insurance utilization for low back pain for 3 years from 1993 to 1995 was calculated as 17.1% for male workers and 19.4% for female workers. Most common cause of utilization was other dorsopathies including the herniation of lumbar discs. 2. The utilization rate increased significantly as the present age and the age joining the company got older(p<0.001). As the duration of employment got longer, the utilization rate of the male showed the tendency to increase and that of the female increased significantly(p<0.05). Among male workers employed at cement and concrete manufacturing companies showed higher utilization rate and among female laborers showed significantly higher utilization rate than clerical workers(p<0.01). 3. Annual utilization rate for low back pain didn't show any difference, but the portion of other dorsopathies among cause of utilization showed the tendency to increase from 1993 to 1995. 4. The mean number of claims for outpatient medical care for low back pain differed significantly by age, working duration, type of industries, income level(p<0.05), and the mean of total visiting days for care of low back pain differed siginificantly by working duration. In conclusion, considering the fact that the medical insurance utilization for low back pain increased annually and other dorsopathies including the herniation of dorsopathies were increasing, an effective preventive or management program for low back pain toward worker employed at industries were required.; Summary

A Study on the low back pain and its associated factors of the staffs in a university.: So Yeon Ryu, Chul Gab Lee, Jong Park, Ki Soon Kim, Yang Ok Kim; Korean J Prev Med. 1996;29(3):679-692.

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Abstract PDF: This study was performed to find the prevalence and the associated risk factors with low back pain(LBP) of the staffs in a university at Kwang-ju city. The data were collected by a questionnaire including SDS(Self-rating depression Scale) battery from September 1st to October 15th, 1996. The results were as follows; 1. The prevalence rate of LBP during lifetime was 73.1%, 53.1% for the last one year, and 23.6% for the last one week. 2. Statistically significant factors related to LBP during lifetime were sex and satisfaction with job. Sex, smoking, alcohol drinking, occupation, work posture, forward bending of trunk and satisfaction with job were selected as significant factors related to LBP during the last one year. The significant determinants related with LBP during the last one week were sex, smoking, alcohol drinking, occupation, forward bending of trunk and satisfaction with job. 3. Through the analysis of self-rating depression scores according to LBP during lifetime were selected to be female(OR=2.63, 95% CI: 1.08~6.40), dissatisfaction with job(OR=2.16, 95% CI: 1.16~4.15), those for the last one year were chosen to be female(OR=2.30, 95% CI: 1.03~5.12), forward bending of trunk(OR=2.18, 95% CI: 1.26~3.79), dissatisfaction with job(OR=1.84, 95% CI: 1.06~3.21), and those for the last one week were female(OR=3.00, 95% CI: 1.17~7.69), forward bending of trunk(OR=2.85, 95% CI: 1.38~5.88). In conclusion, for effective prevention of the LBP at work site, appropriate improvement of work posture and various psychological factors should be considered.; Summary

Cost-Benefit Analysis of Back School Program for Occupational Low Back pain Patients.: Yeong Su Ju, Mi Na Ha, Sang Hwan Han, Ho Jang Kwon, Soo Hun Cho, Chang Yup Kim, Sun Min Kim; Korean J Prev Med. 1996;29(2):347-358.

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Abstract PDF: Although occupational low back pain accounts for 20~40% of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and functional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. we estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson(1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of 30~45%, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.; Summary

The Risk Factors of Industrial Low Back Pain among Shipyard Workers.: Yun Chul Hong, Eun Hee Ha, Hye Sook Park; Korean J Prev Med. 1996;29(1):91-102.

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Abstract PDF: Low back pain patients an controls of shipyard workers were surveyed between June 1995 and september 1995 to identify risk factors of industrial low back pain. The patients were 17 male workers who had got medical treatment for over 3 days because of industrial back pain controls were 51 male workers who had not have musculoskeletal disorder for one year before the survey. By univariate analysis, the workers who did overtime work 4 times or more for the last 2 weeks showed odds ratio of 3.67 on low back pain with the workers who did less overtime work. Carrying heavy materials was also associated with the low back pain and the odds ratio increased with the increase of carrying weight. work space and work posture were not associated with the low back pain significantly. The welder had higher odds ratio than the other workers on low back pain. The duration of employment and job satisfaction did not affect the risk of low back pain. Multiple logistic regression analysis showed that frequency of overtime work for the last 2 weeks and carrying heavy materials among the risk factors were associated significantly with the low back pain. We found that important risk factors of low back pain of shipyard workers are work intensity factors such as overtime work and carrying heavy weight.; Summary

Psychometric Charateristics of Occupational Low Back Pain Patients.: Mi Na Ha, Soo Hun Cho, Ho Jang Kweon, Sang Hwan Han, Young Soo Joo, Nam Jong Pack; Korean J Prev Med. 1995;28(3):715-725.

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Abstract PDF: This study was done for identifying the factors which affect psychologic symptoms of low back(LBP) patients. The study subjects were 43 work-related low back pain patients, 28 work-related non-low back pain patients and 47 general low back injury patients. The study material is SCL 90-R for checking psychologic symptoms and questionnaire for obtaining general information about the subjects. The data were analyzed by model of analysis of covariance adjusted by several variables such as gender, age, education and marital status and then compared the least square means of symptom score between groups. To identify the factors that affect psychologic symptom, duration of suspension, return to work and interaction factor of these two variables were analyzed by multivariate model and we calculated partial correlation coefficient of these variables. As a result, work-related LBP patients showed higher score of symptoms in somatization, depression and psychosis than work-related non-LBP and non-work-related LBP. Duration of suspension and return to work were significant explanatory variables for psychologic symptom score of work-related LBP. Then, we may conclude that the treatment and rehabilitation programe for work-related LBP should cover the strategy of early return to work.; Summary

A study on the development of low back pain and the risk factors of manufacturing workers.: Am Park; Korean J Prev Med. 1993;26(1):37-48.

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Abstract PDF: This study was conducted to investigate the prevalence rate of low back pain during past one year and its risk factors. The data were collected form 1,384 manafacturing factory workers from March 1, 1992 to August 30, 1992. The results obtained were as follows: 1. The one year prevalence rate of low back pain by manufacturing company was 38.4% in textile manufacturing, 35.2% in concrete reenforcement, 31.0% in cigarette and 26.1% in metal part(P<0.01). 2. In textile manufacturing, age groups with high prevalence rate of low back pain were 30's (36.8%) and 40's (36.4%) (P<0.05), and the one year prevalence rates of low back pain by marital state were 34.9% in married workers and 28.5% in unmarried(P=0.0511). 3. The one year prevelence rates of low back pain by job part are 35.0% in labor workers and 26.1% in clerical(P<0.05), and by work hour per day it was 34.9% in 9 or more and 28.9% in 8 or less (P<0.05). 4. The highest group of low back pain by work posture was 43.5% in 'lifting and transfering materials', and it by fitness of chair was 56.0% in uncomfortable one, and by height of working board was 33.6% in low working one. 5. In logistic regression analysis, significant determinants with low back pain were marital state (P<0.05), work hour per day(P<0.05), height of working board(P<0.01), and work posture(P<0.01).; Summary

Risk factors of work-related low back pain in manufacturing workers.: Dae Hwan Kim, Jung Ho Kim, Hae Lim Shin, Jin Ho Chun, Yong Wan Kim, Chae Un Lee; Korean J Prev Med. 1993;26(1):20-36.

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Abstract PDF: Work-related low back pain is one of the major factors that cause the loss of working power especially in actively working age, therefore controlling the work-related low back pain is one of the major issues in the field of industrial safety and health. This study was performed for detecting the risk factors and proposing the efficient control program of the work-related low back pain. The subjects were male workers employed at the manufacturing industry in Pusan with longer than 6 month's working duration. The data was collected by self-reported questionnaire and interview from May 1 to October 31, 1992. The contents of questionnaire were as follows : the experience of low back within the recent one month, general characteristics(age, marital status, education level, religion, regular exercise), physical characteristics(height, weight), employment status(working duration, daily working hours, rest during work, satisfaction for the job), type of work and working environments(posture, forward bending, lifting and movement, satisfaction for table and chair). The result was analyzed for 608 entire respondents by case-control comparative method. The number of cases was 152 with a history of work-related low back pain, so the relative frequency of self-reported work-related low back pain was 25.0%, and the number of controls was 344 without any history of low back pain. As a result, two characteristics of the employment status(working duration, satisfaction for the job) and all characteristics of type of work and working environments showed a statistical significance between the case and control groups(p<0.01). The Odds ratios of these variables for Work-related low back pain were calculated. They were 7.88 for the satisfaction for chair, 7.86 for lifting and movement, 3.31 for satisfaction for table, and 2.22 for bending forward(p<0.01). And for the multivariate logistic regression analysis confirmed that unsatisfaction for table was independent risk factor for Work-related low back pain. In summary, though this study was based upon the self-reported questionnaire and the subjective complaints, the satisfaction for chair, lifting and movement, satisfaction for table, and bending forward concerned with the type of work and working environments were considered as the main factors causing the work-related low back pain, and the work-related low back pain may be preventable by the ergonomic control of these factors.; Summary

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