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Outcome of low back pain in general practice: a prospective study
P R Croft1, G J Macfarlane, A C Papageorgiou
1University of Keele, School of Postgraduate Medicine, Industrial and Community Health Research Centre, Hartshill, Stoke on Trent ST4 7QB.
Objectives:
To investigate the claim that 90% of episodes of low back pain that present to general practice have resolved within one month.
Design:
Prospective study of all adults consulting in general practice because of low back pain over 12 months with follow up at 1 week, 3 months, and 12 months after consultation.
Setting:
Two general practices in south Manchester. 490 subjects (203 men, 287 women) aged 18-75 years.
Main Outcome Measures:
Proportion of patients who have ceased to consult with low back pain after 3 months; proportion of patients who are free of pain and back related disability at 3 and 12 months.
Results:
Annual cumulative consultation rate among adults in the practices was 6.4%. Of the 463 patients who consulted with a new episode of low back pain, 275 (59%) had only a single consultation, and 150 (32%) had repeat consultations confined to the 3 months after initial consultation. However, of those interviewed at 3 and 12 months follow up, only 39/188 (21%) and 42/170 (25%) respectively had completely recovered in terms of pain and disability.
Conclusions:
The results are consistent with the interpretation that 90% of patients with low back pain in primary care will have stopped consulting with symptoms within three months. However most will still be experiencing low back pain and related disability one year after consultation.