| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 2707455 | PM&R | 2012 | 8 Pages |
ObjectiveTo determine the frequency and the characteristics of low back pain (LBP) recurrences. The research questions were as follows: (1) Are LBP recurrences common? (2) Do episodes worsen with multiple recurrences? (3) Does pain change location in any recognizable pattern during an episode?DesignSingle-page self-administered questionnaire.SettingThirty clinical practices (primary care, physical therapy, chiropractic, and surgical spine) in North America and Europe.PatientsA convenience sample of 589 respondents with LBP. There were no exclusions based on type of LBP, history of onset, or comorbidities.MethodsThe survey was distributed during patients' assessment or initial treatment at their respective clinics. The survey queried the following: (1) the severity of original versus most recent episodes based on the following: pain intensity, interference with leisure and work activities, duration of episodes, and most distal extent of pain; and (2) changes in pain location within episodes.ResultsIn response to research question 1, a previous episode was reported by 73%; of those, 66.1% reported their first episode lasted ≤3 months, 54% reported ≥10 episodes, and 19.4% reported >50 episodes. In response to research question 2, of those with recurrences, 61.1% reported that at least one of the survey domains was worse in recent episodes (P < .01) and only 36.9% reported that they were better; 20.5% were worse in all domains, whereas 8.6% were better or the same. In response to research question 3, the pain location changed during the episode in 75.6%; of these, 63.2% reported that their pain first spread distally before retreating proximally during recovery; there was a strong trend toward those reporting worsening episodes also reporting proximal-to-distal-to-proximal changes in pain location during their episodes (r = 0.132, P < .06).ConclusionRecurrent LBP episodes were common and numerous. Recurrences often worsened over time. It seems inappropriate to characterize the typical course of LBP as benign and favorable.
