Prognosis in Acute Low Back Pain

I was reading through some of the evidence on acute low back pain and thought this was interesting. How many times do you hear “it will settle in 6 weeks with or without your physio. Just wait and see!”. Take a look at this research.

Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study

Nicholas Henschke et al

Objective To estimate the one year prognosis and identify prognostic factors in cases of recent onset low back pain managed in primary care.

Design Cohort study with one year follow-up.

Participants 973 consecutive primary care patients (mean age 43.3, 54.8% men) with non-specific low back pain of less than two weeks’ duration recruited from the clinics of 170 general practitioners, physiotherapists, and chiropractors.

Results Only 72% of participants had completely recovered 12 months after the baseline consultation. Older age, compensation cases, higher pain intensity, longer duration of low back pain before consultation, more days of reduced activity because of lower back pain before consultation, feelings of depression, and a perceived risk of persistence were each associated with a longer time to recovery.

Conclusions In this cohort of patients with acute low back pain in primary care, prognosis was not as favourable as claimed in clinical practice guidelines. Recovery was slow for most patients. Nearly a third of patients did not recover from the presenting episode within a year.

With such high rates of suffering amongst our patients, perhaps we have a duty of care to do more than “wait and see.”
BMJ. 2008; 337: a171.
Published online 2008. doi:  10.1136/bmj.a171
PMCID: PMC2483884