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Acute low back pain: systematic review of its prognosis

作者:Liset H. M. Pengel, Robert D Herbert, Chris G Maher, Kathryn M Refshauge · 发表于:BMJ · 年份:2003 · DOI:10.1136/bmj.327.7410.323 · 被引用次数:880 · 研究领域:Musculoskeletal pain and rehabilitation、Spine and Intervertebral Disc Pathology、Occupational Health and Performance

OBJECTIVES: To describe the course of acute low back pain and sciatica and to identify clinically important prognostic factors for these conditions. DESIGN: Systematic review. DATA SOURCES: Searches of Medline, Embase, Cinahl, and Science Citation Index and iterative searches of bibliographies. MAIN OUTCOME MEASURES: Pain, disability, and return to work. RESULTS: 15 studies of variable methodological quality were included. Rapid improvements in pain (mean reduction 58% of initial scores), disability (58%), and return to work (82% of those initially off work) occurred in one month. Further improvement was apparent until about three months. Thereafter levels for pain, disability, and return to work remained almost constant. 73% of patients had at least one recurrence within 12 months. CONCLUSIONS: People with acute low back pain and associated disability usually improve rapidly within weeks. None the less, pain and disability are typically ongoing, and recurrences are common.