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Charting the Course of Lower Back Pain

January 26, 2024 from Medscape


Recent analysis on patients with backpain revealed that those who experienced persistent back pain for less than 12 weeks were more likely to have reduced substantial pain over time. However, patients who had longer periods of persistent back pain, continuing for longer than 12 weeks, had a lower probability of seeing improvement.


The author of the study, Lorimer Moseley, AO, DSc, PhD, professor of clinical neurosciences and chair of physiotherapy at the University of South Australia in Adelaide commented on the  analysis results. Moseley stated that “The outcomes for acute pain are better than we thought they were,”.


A 2012 systematic review and meta-analysis was significantly updated and improved upon in the work headed by Moseley and colleagues. This time, eliminating retrospective cohorts and interventional studies, the researchers examined 95 papers to determine the clinical trajectory of low back pain over various time periods.


The results provide a complex picture of how pain changes over time. Between baseline and six weeks, there is a significant improvement for individuals experiencing acute pain, with a mean pain score decreasing from 56 to 26. In a similar vein, but less clearly, individuals with subacute pain show improvement over the same time period, with their mean pain score falling from 63 to 29. Though there has been some improvement, persistent pain still presents a significant problem, with the mean pain score falling from 56 to 48 after six weeks.


Moseley draws attention to an important finding: the likelihood of recovery declines dramatically after three months, especially for people who are dealing with chronic pain. To strengthen comprehension and improve prognostic markers, additional study and individual patient data analysis are necessary, as the analysis highlights a lack of clarity surrounding this subgroup.


Clinical professor of rheumatology David Borenstein, MD, recognizes the extensive scope of the study’s literature search. He highlights the significance of identifying people at risk of protracted suffering as well as the societal ramifications of low back pain. Additionally, Borenstein emphasizes the need to investigate ways to slow down the transition from acute to chronic pain, indicating that he would like to see more practical implications from the study’s conclusions.


Although the research provides insightful information on the progression of low back pain, it also emphasizes the need for more tailored interventions and nuanced methods, particularly for individuals who are at risk of developing chronic back pain. In addition to improving prognostic markers, future research in this area should open the door to more individualized and successful treatment plans for those suffering from this widespread illness.






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