Two articles on PainSci cite Pengel 2003: 1. The Complete Guide to Low Back Pain 2. 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.
- “Clinical course and prognostic factors in acute low back pain: an inception cohort study in primary care practice,” Coste et al, British Medical Journal, 1994.
- “Prognosis for patients with chronic low back pain: inception cohort study,” Costa et al, British Medical Journal, 2009.
- “The prognosis of acute and persistent low-back pain: a meta-analysis,” Costa et al, CMAJ, 2012.
- “The annual incidence and course of neck pain in the general population: a population-based cohort study,” Côté et al, Pain, 2004.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.