I understand your concerns.
Primary spontaneous pnemothorax is thought to develop when a small air blister( bleb) on the top of the lung ruptures. Blebs are caused by weakness in the lung tissue and can rupture from changes in air pressure when you're scuba diving,flying, mountain climbing because of unequally transmitted pressure changes in the lung.
Avoiding these would help in recurrent severe complications.
Since you have already ruled out smoking
In some cases genetic factor may play a role because this condition may run in families.
And also since you have mentioned
back pain, it would be advisable to rule out
ankylosing spondylitis which can be one of the rare associations with spontaneous pnemothorax
Recurrences of
spontaneous pneumothorax is known to occur in 50% of patients within 3yrs
The best preventive procedure is Video assisted thoracic surgery(VATS) in which belbs are stapled and
pleurodesis is done while in some medical centers
thoracotomy is done.
These procedures are recommended when catheter aspiration fails to resolve spontaneous pbemothorax or if it recures frequently. Recurrence after these procedures is