Social Health Factors Associated with the Transition from Acute to Chronic Low Back Pain

PROJECT SUMMARY AND ABSTRACT
Chronic low back pain (LBP) is extremely common worldwide yet poorly understood due to its multidimensional
complexity of biological, psychological, and sociological factors. Social determinants of health are non-medical
factors that influence health outcomes and can be measured partly by sociodemographic factors and social
health factors (i.e., social isolation, social participation, and social roles). An individual’s social factors may
interact with that individual’s biology during an acute LBP episode by influencing specific immune responses,
which may provide two pathways for interventions to prevent the development of chronic LBP. The goal of this
proposed project is to elucidate the relationship between social and biological factors’ influence on the transition
from acute to chronic LBP. To achieve this goal, we will use extant data on participants experiencing an episode
of acute LBP and determine if sociodemographic and social health factors influence the transition to chronic LBP
at three months. Then we will begin exploring the role of the immune system in this model by cross-sectionally
examining the association between social factors and the immune system during an acute episode of LBP. The
overall hypothesis of this proposal is that social factors are directly associated with the transition from acute
to chronic LBP and may influence biological pathways initiated during an acute episode of LBP. This
proposal will achieve the goals of the proposed study in three specific aims: first, by determining if race or racial
identity is associated with the transition from acute to chronic LBP; second, by determining if social health factors
are associated with the transition from acute to chronic LBP, as well as examining the potential moderating effect
of race on this relationship; third, by identifying the relationships between social factors and the immune system
during acute LBP. These aims will advance our knowledge of risk factors for developing chronic LBP. The
proposed work will have broad clinical implications for treating, managing, and/or preventing chronic LBP through
potential targeted treatments of social health risk factors (i.e., isolation, roles, or participation) or potential
immunotherapy treatments for sub-groups (i.e., race) at high risk for transition to chronic LBP.

Grant Number: 5F31AR084911-02
NIH Institute/Center: NIH
Principal Investigator: Colleen Burke