A estratificação de risco está associada a fatores clínicos, sociodemográficos e psicossociais em indivíduos com dor lombar crônica não específica?

Abstract

Introduction: Non-specific chronic low back pain (NSCLBP) is a prevalent and disabling condition that imposes a high economic burden on healthcare systems and the population. Among the various approaches available for the proper management of this health condition, risk stratification using the Start Back Screening Tool Questionnaire (SBST) stands out. The use of this approach has proven effective, mainly because it guides appropriate interventions that reduce pain, disability, and dysfunctional beliefs. Due to its low cost and easy application, its use in primary healthcare is particularly noteworthy, favoring early and personalized management. However, this approach is still underused in Brazil and further research is needed to expand its application. Objectives: To characterize the sociodemographic, psychosocial, and clinical profile of patients with NSCLBP and analyze how these characteristics behave when stratified according to the risk of poor prognosis for NSCLBP. Method: This cross-sectional study included adults aged 18 to 59 years with self-reported NSCLBP lasting more than 12 weeks. The study was approved by the Institutional Ethics Committee (CAAE: 6.280.686). Questionnaires and scales were applied to assess sociodemographic characteristics and variables such as pain intensity (Numeric Pain Rating Scale – NPRS), disability (Roland-Morris Disability Questionnaire – RMDQ), quality of life (EuroQol Quality of Life Questionnaire – EQ-5D-3L), self-efficacy (Low Back Activity Confidence Scale – LoBACS), fear and beliefs (Fear Avoidance Beliefs Questionnaire – FABQ), and risk of poor prognosis (Start Back Screening Tool Questionnaire – Brazil – SBST-Brazil). Descriptive analysis was performed using SPSS 2.7 software. Results: A total of 76 individuals were evaluated, with a predominance of females (63.16%), regular physical activity practice (56.58%), no frequent use of medication (63.16%), and complete or incomplete higher education (51.32%). Most participants were classified as medium risk (42.11%), followed by low risk (35.53%) and high risk (22.37%). The mean ages were 35.15 years (±2.9) in the low-risk group, 36.31 (±2.2) in the medium-risk group, and 37.6 (±3.4) in the high-risk group. Body mass index (BMI) presented means of 25.67 (±1.14), 27.36 (±0.8), and 37.6 (±3.4), respectively. Pain intensity scores were 5.3 (±0.34), 6.63 (±0.30), and 7.81 (±0.50), while disability scores were 6.22 (±0.78), 9.66 (±0.84), and 15.8 (±1.37). Quality of life, assessed by utility scores, was 0.66 (±0.02), 0.61 (±0.01), and 0.47 (±0.41). Self-efficacy showed mean scores of 81.01 (±2.67), 73.31 (±2.2), and 97.27 (±32.9), and fear and belief scores were 29.52 (±2.16), 31.91 (±2.2), and 45.7 (±2.8), respectively. Discussion and Conclusion: The results indicate that most individuals evaluated presented a moderate risk for pain and dysfunction, despite the predominance of protective characteristics such as regular physical activity practice and lower medication use. A worsening trend was observed in clinical and functional indicators as the level of risk increased, especially in the domains of pain, disability, quality of life, and dysfunctional beliefs. These findings reinforce the importance of risk stratification as a tool to guide individualized interventions in primary healthcare.