Recovery from chronic back pain proved likely

Australian research published on bmj.com reports that over a third (35%) of patients will recover from chronic low back pain within nine months and four out of 10 (41%) will do so within a year.

This groundbreaking study reveals findings that are contrary to the broad theory that recovery from an episode of chronic low back pain is doubtful.

Dr Luciola Menezes Costa, from the University of Sydney is the lead author. She reports that individuals were more likely to have delayed recovery if they had a prior sick leave due to low back pain, high disability levels, low levels of education and were born overseas.

The authors explain that chronic low back pain is a major health problem. It places an enormous social and economic burden on society. In addition, they argue that there is presently significant doubt associated with recovery rates.

The participants came from a larger group of 973 patients. They all attended primary care clinics in Sydney with a new episode of low back pain. These patients had visited their health care provider with acute low back pain which is defined as an episode lasting for more than 24 hours but less than two weeks.

Patients with serious spinal health problems such as cancer, infection, fractures or inflammatory arthritis were withdrawn from the study. Those who had not recovered by 90 days were categorised as having chronic non-specific low back pain and joined the current study.

The researchers monitored 400 patients with chronic non-specific low back pain. Through a telephone interview they evaluated pain and disability levels, as well as work status nine and 12 months later. The results indicate that a considerable number of participants had full recovery within a year of first developing chronic low back pain.

A total of 35% recovered by nine months and 41% by one year.

In closing, Dr Menezes Costa comments that this study is significant as it demonstrates that the rate of recovery from chronic low back pain is superior to what was previously reported. The findings imply that the prognosis is not consistently poor for patients with chronic low back pain.

Also, the authors note that the results should be encouraging for patients since they demonstrate that recovery from a new episode of chronic non-specific low back pain is probable.

On the other hand, in an associated editorial, two senior researchers from Keele University remark that when considering a condition like low back pain that many people endure for a lifetime, research on patient outcome should take into account much longer time scales.

They write that further research can develop our understanding about the different patterns that come out and their order, why some people recover whereas others have episodic pain for years or develop long term constant pain.