Is there an association between post-traumatic stress disorder and the incidence of chronic low back pain?

Background: Preliminary research suggests post-traumatic stress disorder (PTSD) is a risk factor for chronic low back pain (CLBP). However, this literature displays some limitations. Therefore, this study aimed to investigate the association between PTSD and the 10-year cumulative incidence of CLBP in adults from Germany. 

Methods: The present retrospective cohort study included adults diagnosed with PTSD in one of 1,284 general practices in Germany in 2005-2020 (index date). Individuals without PTSD were matched to those with PTSD (1:1) using a propensity score based on age, sex, index year, duration of follow-up, and the mean number of consultations during follow-up. In patients without PTSD, the index date was a randomly selected visit date. 

Results: There were 60,664 patients included in the study. After adjusting for frequent comorbidities, there was a positive but non-significant association between PTSD and incident CLBP in the overall population (HR=1.07, 95% CI=0.99-1.15). Nonetheless, the relationship between PTSD and CLBP was statistically significant in the age group >60 years (HR=1.24, 95% CI=1.05-1.46).

Conclusions: Conversely to previous research, PTSD was not associated with incident CLBP in this large German sample. Further longitudinal studies are warranted to corroborate these findings before drawing any firm conclusions.