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. 2003 Aug 9;327(7410):323.
doi: 10.1136/bmj.327.7410.323.

Acute low back pain: systematic review of its prognosis

Liset H M Pengel  1 , Robert D Herbert, Chris G Maher, Kathryn M Refshauge
Affiliations

Acute low back pain: systematic review of its prognosis

Liset H M Pengel et al. BMJ. .

Abstract

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.

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Figures

Fig 1
Fig 1
Means (95% confidence intervals) for pain (top) and disability (bottom) during 12 months after onset of acute low back pain
Fig 2
Fig 2
Means (95% confidence intervals) for return to work during 12 months after onset of acute low back pain of those initially off work. Reid et al report proportion returned to work, including those who returned to work and subsequently left work
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