Acute low back pain: systematic review of its prognosis
Two pages 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.
related content
- “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:
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.
- Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. Aasdahl 2021 BMC Musculoskelet Disord.
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.