Prognosis of a new episode of low-back pain in a community inception cohort

Background: Most studies investigating the prognosis of low back pain (LBP) enrol people presenting for care, rather than all people who have an episode of LBP. We aimed to describe the prognosis of an acute episode of LBP in a community inception cohort.

Methods: We used data from two previous studies investigating recurrence of LBP. Participants without current LBP were contacted monthly to assess if they had experienced a new episode of LBP. 366 participants reporting a new episode of LBP were included in the current study. The primary outcome was duration of the new episode of LBP. Secondary outcomes were average and worst pain during the episode and the proportion of participants seeking care.

Results: The median duration of the episode was 5 days (95% CI 3.99 to 6.02). The cumulative probability of recovery was 70.0% (95% CI 65.3 to 74.7) before 1 week, 86.1% (95% CI 82.6 to 89.6) before 3 weeks, 90.9% (95% CI 88.0 to 93.8) before 6 weeks, and 93.5% (95% CI 90.8 to 96.0) before 12 weeks. The mean average pain intensity was 3.7 (SD ± 1.5), and the mean worst pain intensity was 5.6 (SD ± 1.9). The proportion of patients who sought care was 39.5% (95% CI 33.9 to 46.4).

Conclusions: This study found most episodes of LBP recover rapidly and more quickly than typically reported for clinical populations. The worst pain during the episode was typically moderate despite the rapid recovery for most people. Approximately 40% of the participants who experienced an episode of LBP sought care.

Significance: This study describes the prognosis of an acute episode of LBP in a community inception cohort. This study found the majority of episodes of LBP, in community-dwelling adults, recover rapidly (median of 5 days) and more quickly than typically reported for clinical populations. The community should be reassured about the favourable prognosis of acute LBP.