Predicting Results after Subacute Low Back Pain
What we don't know about back pain could fill volumes. Back pain of unknown cause can be acute (lasting up to three weeks), subacute (four to 12 weeks), or chronic (lasting more than three months). Our understanding and treatment of back pain is based on these three groupings.
Studies have shown that some factors can predict absence from work after an acute episode of low back pain. Knowing what factors predict recovery from chronic back pain would also be helpful. Right now, it's still a mystery. These researchers in Finland are trying to help solve it.
Doctors from the Department of Occupational Medicine recruited 164 adult workers with disabling back pain for this study. All subjects had subacute back pain. The workers were put in one of three different study groups.
Everyone answered questions about sick leave, pain levels, and quality of life. They also told the researchers about their overall satisfaction with medical care. Cost of health care visits was calculated. This included visits to the doctor, nurse, or physical therapist, as well as drugs, hospital care, and X-rays and other imaging studies.
Here's what they found:
Pain was higher when workers thought they wouldn't get better. Older workers had a higher risk of daily symptoms and pain getting in the way of work or daily life. Pain going down the leg and below the knee is common in workers with continued back pain. Younger workers were more likely to report a better quality of life. Older age is linked with higher health care costs related to back pain. Blue-collar workers used more sick leave than white-collar workers.
The authors conclude that there are several factors best able to predict recovery from subacute back pain. Age and intensity of pain are the two most important predictors. Workers who used sick leave for back pain before are more likely to use sick leave again.
Kaija Karjalainen, MD, et al. Outcome Determinants of Subacute Low Back Pain. In Spine. December 1, 2003. Vol. 28. No. 23. Pp. 2634-2640.