Acute Low Back Pain - It won't last long. Evidence from a recent study
An episode of acute low back pain (ALBP) can have significant psychosocial implications for the sufferer. It can engender a strong sense of fear, particularly in those for whom it is their first episode.
The belief that LBP is associated with long-term disability is common in first-time patients, and even in many who have recovered. Luckily, anecdotal and research evidence paints a different picture. The prognosis is good for all but a small percentage of people. Full recovery in a relatively short period of time is not only possible but should be expected in patients with uncomplicated LBP.
A recent study examined the physical and functional impact of ALBP on patients. This included those who suffered one or more recurrences over the course of a year. It was conducted through a questionnaire that measured scores of pain intensity, pain interference with normal activities, and overall functional status. Scores ranged from 8 (least impact) to 50 (greatest impact). The questionnaire was completed at 3, 6, 9, and 12 months.
250 participants who were recovering from ALBP were recruited and followed up over one year. The mean age was just under 50 years, with equal numbers of male and female participants. 68% suffered a recurrence of ALBP during the study period.
It was found that the median impact for patients over 1 year was very low – 11.5 points for those who had not, and 15.6 points for those who had, suffered one or more recurrences over the study period. As the minimum possible score was 8 out of 50, these excellent results supported previous prognostic data. The impact score was relatively low even at the early (3 months) follow-up – median 19/50.
This is useful information for those who are worried about the long-term implications of an episode of low back pain. While the likelihood of a recurrence is high (around 70% in this study, and 80-90% in previous studies), these recurrences are generally associated with minimal functional impact, and each episode is likely to settle quickly. In the current study, symptoms resolved over an average of 14 days.
Part of my ALBP management is to provide reassurance and advice to remain active. And I confidently educate my patients that their medium to long-term prognosis is excellent.
Da Silva, T. et al (2020). What is the personal impact of recurrences of low back pain? Sub-analysis of an inception cohort study. JOSPT. Ahead of print: https://www.jospt.org/doi/10.2519/jospt.2020.9345