# Association Between Systemic Symptoms and Recovery in Acute Low Back Pain: A Retrospective Cross-Sectional Study

## TL;DR

This study explores how systemic symptoms like dyspepsia affect recovery in acute low back pain, suggesting they could predict chronicity.

## Contribution

The study identifies systemic symptoms as novel prognostic factors for acute low back pain recovery.

## Key findings

- Dyspepsia is significantly linked to higher pain at discharge and less pain reduction in ALBP patients.
- Alcohol consumption is associated with lower pain at discharge and greater pain improvement.
- Systemic symptoms may serve as early markers for predicting chronic low back pain.

## Abstract

Background: Several prognostic factors, including the early recovery pattern of acute low back pain (ALBP), are related to the chronicity of LBP. However, the association between systemic symptoms and ALBP remains underexplored from a holistic perspective. Hence, this study aimed to investigate this relationship and identify novel clinical prognostic predictors for LBP. Methods: This retrospective cross-sectional study included patients with ALBP admitted to the Department of Korean Medicine Rehabilitation at the Dongguk University Bundang Hospital between 1 January 2021 and 30 April 2025. Data extracted from medical records included demographics, treatment-related information, pain characteristics, past medical history, and systemic symptoms. Statistical analyses included independent t-tests, Mann–Whitney U tests, chi-squared tests, Fisher’s exact tests, correlation analysis, and multiple linear regression models. Results: A total of 194 patients with ALBP were included in the analysis. Among systemic symptoms, dyspepsia was significantly associated with higher pain at discharge and smaller absolute and relative pain changes. Although sleep disturbance and constipation showed associations with higher pain at discharge in univariate analyses, these associations were not statistically significant in regression models. Beyond systemic symptoms, alcohol consumption was significantly associated with lower pain at discharge and greater relative pain change, while hospitalization and symptom duration exhibited non-linear relationships. These findings remained robust in sensitivity and subgroup analyses. Conclusions: Systemic symptoms, especially dyspepsia, may serve as prognostic factors impeding ALBP recovery, representing potential early markers for identifying patients at risk of chronicity. The findings highlight the prospect of multidimensional strategies in reducing pain and enhancing patients’ quality of life in clinical practice.