| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
a The Institute for
Research in Extramural Medicine, b Faculty of Medicine, Vrije Universiteit, Amsterdam,
the Netherlands
Correspondence to: Dr H van den Hoogen, EMGO Institute, Vrije Universiteit, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
Accepted for publication 18 September 1997
OBJECTIVES
Knowledge on the clinical course
of low back pain presented in general practice is poor. Preceding
studies offer a fragmentary view only, whereas further knowledge is
important to enable the assessment of the prognosis. The object of this
study is to investigate the course of low back pain presented in
general practice to enable the assessment of the prognosis.
METHODSA one year follow up study on the clinical
course of low back pain in consecutive cases receiving usual care in
general practice. During a period of two years 15 general practitioners
from Amsterdam and surrounding areas included consecutive patients with
both chronic and recent onset low back pain. After the initial visit, each patient was monitored for a period of 12 months. The follow up
consisted of monthly postal questionnaires on the course of the low
back pain and the related disability.
RESULTSA total of 443 of 605 patients identified
were included in the follow up, which was fully completed by 269 patients. In general, patients with less serious low back pain
participated less often or did not complete the follow up. At 12 weeks
35% and at the end of the follow up 10% of the population,
respectively, still suffered from low back pain. Both the pain and the
disability seemed to diminish quickly after the initial visit, and both
seemed to stabilise at a lower level if the low back pain did not
disappear completely. About three of four patients, whose pain
disappeared before the end of the follow up, endured one or more
relapses within a year. The median time to a relapse was about seven
weeks, and its median duration about six weeks. Both the pain and the disability turned out to be less severe during relapses. The median time to recovery for patients whose low back pain developed more than
seven weeks before the initial visit, was four weeks longer than for
patients with more recently developed low back pain at the initial visit.
CONCLUSIONSThe clinical course of low back pain
presented in general practice, for the most patients, clearly is less
favourable than expected. It takes more than just a few weeks to
recover, and relapses occur within a year in most cases. Fortunately,
both the pain and the disability quickly diminish, even if the low back pain does not resolve within a few weeks.
Relevant Article
This article has been cited by other articles:
|
|
 |
|
  F. H. Shen, D. Samartzis, and G. B.J. Andersson Nonsurgical Management of Acute and Chronic Low Back Pain J. Am. Acad. Ortho. Surg., August 1, 2006; 14(8): 477 - 487. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B W Koes, M W van Tulder, and S Thomas Diagnosis and treatment of low back pain. BMJ, June 17, 2006; 332(7555): 1430 - 1434. [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Dunn, K. Jordan, and P. R. Croft Characterizing the Course of Low Back Pain: A Latent Class Analysis Am. J. Epidemiol., April 15, 2006; 163(8): 754 - 761. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Davidson and J. L Keating A Comparison of Five Low Back Disability Questionnaires: Reliability and Responsiveness Physical Therapy, January 1, 2002; 82(1): 8 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Wernick and S. M. Campbell Update in Rheumatology Ann Intern Med, January 18, 2000; 132(2): 125 - 133. [Full Text] [PDF]
|
|
|
|
|
|
E. Thomas, A. J Silman, P. R Croft, A. C Papageorgiou, M. I V Jayson, and G. J Macfarlane Predicting who develops chronic low back pain in primary care: a prospective study BMJ, June 19, 1999; 318(7199): 1662 - 1667. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. Haigh and A. K Clarke Effectiveness of rehabilitation for spinal pain Clinical Rehabilitation, January 1, 1999; 13(1_suppl): 63 - 81. [Abstract] [PDF]
|
|
|
|
 |
|
 N. M HADLER and T. S CAREY Low back pain: an intermittent and remittent predicament of life Ann Rheum Dis, January 1, 1998; 57(1): 1 - 2. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
