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Good news! Chronic low back pain is less chronic than many people probably thought, according the British Medical Journal.

Chronic Low Back Pain Is Not So Chronic

The prognosis for chronic low back pain is better than most people realize … especially for Australians in Australia!

updated ARCHIVEDArchived pages are rarely or never updated. Most featured articles on PainScience.com are updated regularly over the years, but not archived pages.
by Paul Ingraham, Vancouver, Canadabio
I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about memore about PainScience.com

EXCERPT This article is a summary one key concept in PainScience.com’s low back pain tutorial, which is ridiculously detailed.

If you’ve had chronic low back pain for less than a year, I’ve got great news for you: your ordeal may soon be over. A new Australian study has shown that “prognosis is moderately optimistic for patients with chronic low back pain.” This evidence is the first of its kind, a rarity in low back pain research, a field where almost everything has been studied to death.

“Many studies provide good evidence for the prognosis of acute low back pain,” the authors explain. “Relatively few provide good evidence for the prognosis of chronic low back pain.” Their research differs from past studies of chronic low back pain, which tended to focus on patients who already had a well-established track record of long-term problems: in other words, the people who had already drawn the short straw before they were selected for study, and are likely to carry right on feeling rotten. But what if you study fairly new cases of chronic low back pain? How many of them fade away, and how many of them really drag on? Isn’t that what is of particular interest to any low back pain patient during their first few months of suffering?

So these researchers looked at patients who had not recovered from their new cases of chronic low back pain, and found that “more than one third” recovered within nine more months. That’s a pretty good number.

Yes, of course, that still leaves two third of patients who continue to suffer past the year-mark — and that’s an unfortunate number. However, this is chronic low back pain we’re talking about here! The surprising and promising thing is that so many patients — almost 40% — actually do get better by the one-year anniversary of their pain. These are people who didn’t get better in the first three months, and who would have been told by many doctors that they were officially “chronic” at that point.

The surprising and promising thing is that so many patients — almost 40% — actually do get better by the one-year anniversary of their pain.

Alarmism and fear about low back pain has always been a problem. Patients tend to panic, and many doctors and therapists fail to reassure them that most acute low back pain goes away. But many of those who do reassure them step out of the frying pan and into the fire by simply delaying the alarm for 6–9 weeks: they believe and communicate that if you don’t recover in the first three months, you’re pretty much doomed to have chronic low back pain.

This study shows that it’s not true. You can have low back pain for 3, 6, 9 months … and more than 30% of patients will still recover. This evidence is a great foundation for more substantive and lasting reassurance.

What’s the Australian connection?

Did the people who didn’t recover have anything in common? This study also looked at risk factors, and found some patterns. The patients whose pain just kept going were those who had worse pain, more disability, and more fear (“perceived risk of persistent pain”) — no surprise there. They were also the patients with a history of previous sick leave — not for back pain, but for other things, people who may be generally unwell.

A little more surprising was that they had less education: better educated people recovered more.

And (my favourite) the patients with persistent pain also tended to be non-Australian. That’s right: native Australians in Australia get less chronic back pain than non-Australians in Australia! Not sure what to do with that information — don’t move to Australia and get low back pain, I guess. Sound medical advice!

Whatever you do, don’t move to Australia and get low back pain!

In the low back pain tutorial, I discuss the myth of the chronicity of low back pain in much more detail.

Save Yourself from Low Back Pain!

There are thousands of low back pain books — what’s special about this one? The problem is that 90% of doctors and therapists assume that back pain is structural, in spite of mountains of scientific evidence showing … exactly the opposite. Only a few medical experts understand this, and fewer still are writing for patients and therapists. Supported by 398 footnotes, this tutorial is the most credible and clarifying low back pain information you can find. Ships with a free copy of PainScience.com’s trigger point tutorial! Add it to your shopping cart now ($19.95) or read the first few sections for free!

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About Paul Ingraham

Headshot of Paul Ingraham, short hair, neat beard, suit jacket.

I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.