SIB #367 Recurrence of Low Back Pain

The Study: Recurrence of low back pain is common: a prospective inception cohort study


The Facts:

a. The authors wanted to study recurrence of low back pain in terms of how often and how quickly the pain reoccurred.

b. They used a cohort of 250 subjects that had recently recovered after having an episode of lower back pain.

c. It was a prospective study and the patients were followed on a monthly basis for 12 months.

d. It is known that most people who suffer from acute lower back pain recover fairly quickly.

e. “A recent systematic review investigating the risk of a recurrence of LBP in patients who have recovered from a previous episode concluded that it is not yet possible to obtain robust estimates of the risk of recurrence, due to the heterogeneity and generally poor methodological quality of the small number of existing studies.”

f. Patients in this study group were 18 or older and had recovered from non-specific low back pain within the last month. The lower back pain may or may not have included leg pain.

g. The primary measurement of recurrence was if the patient had a return of the lower back pain which was 2 or greater on an 11 point numerical rating scale and lasted for 24 or more hours.

h. Using uncorrected time, the cumulative probability of a recurrence was as follows: 38% of the participants had a recurrence of lower back pain within 3 months, 56% in 6 months and 69% within 12 months. The median time for recurrence was 139 days using uncorrected time and 146 using the corrected time.

i. Using uncorrected time, the cumulative probability of seeking care for lower back pain for a recurrence: 12% sought care within 3 months, 25% within 3 months and 41% within 12 months

Take Home:

The recurrence rate in this study appears to be higher than previously reported.

Reviewer:  Roger Coleman DC

 Editor: Mark R. Payne DC

 Reference: da Silva T, Mills K, Brown BT, Pocovi N, de Campos T, Maher C, Hancock MJ. Recurrence of low back pain is common: a prospective inception cohort study. J Physiother. 2019 Jul;65(3):159-165. doi: 10.1016/j.jphys.2019.04.010. Epub 2019 Jun 14.

 Link to Abstract:

Mark R. Payne DC