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Acute low back pain: systematic review of its prognosis
Liset H M Pengel1, Robert D Herbert, Chris G Maher
1School of Physiotherapy, University of Sydney, PO Box 170, Lidcombe NSW 1825, Australia.
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.