Based on very low-certainty evidence, individuals with persistent low back pain have minimal improvements over time
By Elana Gotkine HealthDay Reporter
MONDAY, Jan. 22, 2024 (HealthDay News) — Patients with acute and subacute low back pain experience considerable improvements in pain and disability within the first six weeks, according to a review published online Jan. 22 in CMAJ, the journal of the Canadian Medical Association.
Sarah B. Wallwork, Ph.D., from IIMPACT in Health in Adelaide, Australia, and colleagues updated a 2012 systematic review and meta-analysis to improve understanding of the clinical course of acute, subacute, and persistent low back pain. Data were included from 95 studies, with 60 separate cohorts (17,974 participants) in the systematic review and 47 cohorts (9,224 participants) in the meta-analysis.
The researchers found that with inception time uncorrected (i.e., time since study entry), the estimated mean pain score was 56 at baseline, 26 at six weeks, 22 at 26 weeks, and 21 at 52 weeks for the acute pain cohort (moderate-certainty evidence); 63, 29, 29, and 31, respectively, for the subacute pain cohort (moderate-certainty evidence); and 56, 48, 43, and 40, respectively, for the persistent pain cohort (very low-certainty evidence). Compared with the clinical course of pain, the clinical course of disability was slightly more favorable.
“Most people with acute and subacute low back pain begin to improve within the first six weeks, but many have ongoing pain and disability,” the authors write. “Identifying and escalating care among people with subacute low back pain who are recovering slowly seems a critical focus of intervention.”
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