The clinical course of acute, subacute and persistent low back pain: a systematic review and meta-analysis

Review written by Robin Kerr info

Key Points

  1. People with acute low back pain will experience a significant reduction in pain and disability within the first six weeks.
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BACKGROUND & OBJECTIVE

In any given year 39% of the world’s population will have low back pain (LBP) and the related disability (1). It is imperative to understand the clinical course of LBP to inform treatment recommendations.

The authors’ aim was to update their 2012 systematic review (SR) and meta- analysis by investigating the clinical course of acute (<6wk), subacute (6->12wk) and persistent LBP (12->52wk). The authors realized their 2012 SR and meta-analysis had a critical limitation in that subacute (6->12 weeks) subjects were included in the persistent (>12 weeks) pain group analysis. This resulted in favorable outcomes being reported in the 2012 persistent pain group, with subsequent clinical opinion and guidelines being formed on inaccurate results.

In any given year 39% of the world’s population will have low back pain and the related disability.
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Intensive management in subacute patients who do not appear to be improving could be required to determine what modifiable factors require targeting to prevent progression to persistent pain.

METHODS

  • A PROSPERO registered SR and meta-analysis was performed under Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
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