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Abstract
Introduction Low back pain (LBP) is a global health concern. Approximately two-thirds of those who recover from LBP experience a relapse within a year, with many chronic cases encountering acute flare-ups (exacerbation). This systematic review will synthesise and analyse whether physical and/or psychological features can predict recurrent episodes of LBP or exacerbation of pain.
Methods and analysis This systematic review protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Comprehensive literature searches will be conducted in MEDLINE, EMBASE, APA PsycInfo, PubMed, CINAHL Plus, Web of Science, Scopus and ZETOC, spanning from each database’s inception through to January 2025. Google Scholar and grey literature sources, including OpenGrey, will also be searched to ensure comprehensive coverage. Two independent reviewers will screen titles, abstracts and full texts, assessing the risk of bias with a modified Quality in Prognosis Studies tool. The overall certainty of evidence will be evaluated using an adapted Grading of Recommendations Assessment, Development and Evaluation approach. If sufficient data homogeneity is present, a meta-analysis will be performed; otherwise, findings will be synthesised narratively. The results will identify the ability of physical and/or psychological factors to predict pain recurrence or acute exacerbation in case of persistent non-specific LBP.
Ethics and dissemination This study protocol does not present any ethical concerns. The findings from the systematic review will be submitted for publication in a peer-reviewed journal and will also be presented at relevant conferences.
PROSPERO registration number CRD42024599514.
- Chronic Pain
- Back pain
- Musculoskeletal disorders
- Prognosis
- Systematic Review
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Footnotes
X @DrJanetDeane, @Deb_Falla
Contributors The systematic review protocol was developed collaboratively, with input from all authors. The primary reviewers for the study will be KW, CWGY and DF. KW is a PhD candidate, with DF as the lead supervisor and JD and MM as co-supervisors. KW drafted the protocol under DF’s guidance, incorporating detailed feedback from CWGY, JD and MM on manuscript drafts. All authors reviewed and approved the final version for publication. DF acts as the guarantor for the study.
Funding Funding support was provided by the Faculty of Medicine, Prince of Songkla University.
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, conduct, reporting or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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