90% Under Regular Medical Care Still Suffer Low Back Pain 1 Year Later

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Study Overview

1. It is widely believed that 90% of episodes of low back pain seen in general practice resolve within one month
2. In a large population based study we examined the outcome of episodes of low back pain in general practice with respect to both consultation behaviour and self reported pain and disability
3. While 90% of subjects consulting general practice with low back pain ceased to consult about the symptoms within three months, most still had substantial low back pain and related disability
4. Only 25% of the patients who consulted about low back pain had fully recovered 12 months later
5. Since most consulters continue to have long term low back pain and disability, effective early treatment could reduce the burden of these symptoms and their social, economic, and medical impact

Study Abstract

Objectives - To investigate the claim that 90% of episodes of low back pain that present to general practice have resolved within one month.

Design - Prospective study of all adults consulting in general practice because of low back pain over 12 months with follow up at 1 week, 3 months, and 12 months after consultation.

Setting - Two general practices in south Manchester.

Subjects - 490 subjects (203 men, 287 women) aged 18-75 years.

Main Outcome Measures - Proportion of patients who have ceased to consult with low back pain after 3 months; proportion of patients who are free of pain and back related disability at 3 and 12 months.

Results - Annual cumulative consultation rate among adults in the practices was 6.4%. Of the 463 patients who consulted with a new episode of low back pain, 275 (59%) had only a single consultation, and 150 (32%) had repeat consultations confined to the 3 months after initial consultation. However, of those interviewed at 3 and 12 months follow up, only 39/188 (21%) and 42/170 (25%) respectively had completely recovered in terms of pain and disability.

Conclusions - The results are consistent with the interpretation that 90% of patients with low back pain in primary care will have stopped consulting with symptoms within three months. However most will still be experiencing low back pain and related disability one year after consultation.

1. British Medical Journal. 1998;316:1356–9

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