Prognosis in Patients with Recent Onset Low Back Pain in Australian Primary Care
Prognosis in Patients with Recent Onset Low Back Pain in Australian Primary Care: Inception Cohort Study
British Medical Journal 2008 (Jul 7); 337: a171
Henschke N, Maher CG, Refshauge KM, Herbert RD,
Cumming RG, Bleasel J, York J, Das A, McAuley JH.
Musculoskeletal Division,
The George Institute for International Health,
Sydney, Australia.
This BMJ study contradicts previous Clinical Practice Guidelines that suggest that recovery from an episode of recent onset low back pain is usually rapid and complete. Their findings with 973 consecutive primary care patients was that recovery was slow for most patients, and almost 1/3 of patients did not recover within one year (when following standard medical recommendations).
OBJECTIVE: To estimate the one year prognosis and identify prognostic factors in cases of recent onset low back pain managed in primary care.
DESIGN: Cohort study with one year follow-up.
SETTING: Primary care clinics in Sydney, Australia.
PARTICIPANTS: An inception cohort of 973 consecutive primary care patients (mean age 43.3, 54.8% men) with non-specific low back pain of less than two weeks’ duration recruited from the clinics of 170 general practitioners, physiotherapists, and chiropractors.
MAIN OUTCOME MEASURES: Participants completed a baseline questionnaire and were contacted six weeks, three months, and 12 months after the initial consultation. Recovery was assessed in terms of return to work, return to function, and resolution of pain. The association between potential prognostic factors and time to recovery was modelled with Cox regression.