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Acute low back pain: systematic review of its prognosis

PainSci » bibliography » Pengel et al 2003
Tags: back pain, pain problems, spine

Two articles on PainSci cite Pengel 2003: 1. The Complete Guide to Low Back Pain2. Chronic Low Back Pain Is Not So Chronic

PainSci notes on Pengel 2003:

Many studies over the years that have shown roughly the same thing: most people recover relatively quickly and well. This old review of 15 such studies calculated an average of 58% reduction both pain and disability within a month, and then some more within another month.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVES: To describe the course of acute low back pain and sciatica and to identify clinically important prognostic factors for these conditions.

DESIGN: Systematic review.

DATA SOURCES: Searches of Medline, Embase, Cinahl, and Science Citation Index and iterative searches of bibliographies.

MAIN OUTCOME MEASURES: Pain, disability, and return to work.

RESULTS: 15 studies of variable methodological quality were included. Rapid improvements in pain (mean reduction 58% of initial scores), disability (58%), and return to work (82% of those initially off work) occurred in one month. Further improvement was apparent until about three months. Thereafter levels for pain, disability, and return to work remained almost constant. 73% of patients had at least one recurrence within 12 months.

CONCLUSIONS: People with acute low back pain and associated disability usually improve rapidly within weeks. None the less, pain and disability are typically ongoing, and recurrences are common.

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