Back pain recovery slower than common belief suggests

Jul 9 2008

A study by Australian researchers has found that recovery from low back pain is much slower than previously thought and is even slower for those with an injury which warrants compensation.

The researchers at the George Institute for International Health say their results are contrary to current guidelines and common belief.

The study showed that nearly one third of patients did not recover from the original episode of back pain within a year which is not as favourable as clinical practice guidelines suggest, which is that 90 per cent of patients recover within four to six weeks, with or without treatment.

Professor Chris Maher, the lead author says these are extremely important results because they confirm that low back pain is a significant health problem and that there is substantial room for improvement in its management.

For the study the researchers recruited 973 patients with an average age of between 43 - 54 who had suffered acute low back pain for at least two weeks, from the clinics of 170 general practitioners, physiotherapists, and chiropractors.

Each participant completed a questionnaire at the outset and were then contacted six weeks, three months, and 12 months after the initial consultation, recovery was assessed in terms of return to work, return to function, and resolution of pain.

The follow-up after 12 months found that recovery was slow for most patients and only 72% of participants had completely recovered.

On a daily basis 12-33% of people suffer low back pain and the costs of treatment are enormous. In Australia, with a population of 21 million people, the treatments costs are about $A1 billion each year, with indirect costs exceeding $8 billion.

The study revealed that even with treatment, after two months only 50 per cent had fully recovered from the original episode of pain and after one year about 40 per cent reported that their back was still causing them pain.

Professor Maher says the results challenge the accepted view that recovery is rapid following an episode of acute low back pain, as for many people back pain becomes a long-term problem that severely impacts their life.

He says this is despite receiving what is regarded to be the best possible care and a rethink of our approach is needed.

Professor Maher says compensation appeared to halve the chances of recovery which suggests the compensation system needs to be reviewed.

The researchers say there is evidence that the type of advice given to patients can alter the course of an episode of low back pain.

The research is published in The British Medical Journal.