The Prognosis of Acute Low Back Pain in Primary Care in the United States: A 2-Year Prospective Cohort Study
Mehling WE et al. – The prognosis of strictly defined acute Low Back Pain (LBP), with or without sciatica, is less favorable than commonly stated in practice guidelines based on failure to return to work. Broad initiatives to develop new means for the primary and secondary prevention of recurrent and chronic LBP are urgently needed.Methods
- Members of a large health service organization were enrolled after seeking medical care for acute LBP, with or without sciatica, of up to 30 days duration, with no episode in the past 12 months and no history of spine surgery.
- The authors conducted phone interviews at baseline, 6 months, and 2 years.
- Based on receiver operating characteristic analyses, a combination of global perceived recovery with pain intensity was used as primary outcome for chronic pain.
- Recurrence and multiple secondary outcomes were assessed to allow for comparison with other studies.
- Six hundred five patients had an average pain intensity of 5.6 (numeric rating scale = 0–10) and disability of 15.8 (Roland–Morris scale = 0–24).
- Eight percent had declared sick leave between pain onset and baseline interview.
- Thirteen percent of 521 patients (86% follow–up) experienced chronic pain at 6 months and 19% of 443 patients at 2 years.
- At 6 months, 54% had experienced at least 1 LBP recurrence, and 47% in the subsequent 18 months.