While the study found that many people
recovered within a year, there are also
many who never recover from chronic
back pain - for reasons that are still
not understood.
Image: iStockphoto

Over a third (35 per cent) of patients will recover from chronic low back pain within 9 months and 4 out of 10 (41 per cent) will do so within a year, according to research published on bmj.com today.

This is the first study of its kind and the results go against the common view that recovery from an episode of chronic low back pain is unlikely.

The lead author, Dr Luciola da Menezes Costa, from The George Institute at the University of Sydney, says individuals with previous sick leave due to low back pain, high disability levels, low levels of education and being born overseas were more likely to have delayed recovery.

Chronic low back pain is a major health problem, say the authors, and places a huge social and economic burden on society. They also argue that there is currently considerable uncertainty associated with recovery rates.

The participants were drawn from a larger group of patients who attended primary care clinics in Sydney with a new episode of low back pain. These patients had visited their health care provider with acute low back (meaning that the episode had lasted for more than 24 hours but less than two weeks). Patients with serious spinal health problems such as cancer, infection, fractures or inflammatory arthritis were excluded from the study. Those who had not recovered by 90 days were considered to have chronic non-specific low back pain and joined the current study.

The researchers followed up 400 patients with chronic non-specific low back pain with a telephone interview assessing pain and disability levels and work status 9 and 12 months later. The results reveal that a reasonable number of participants had complete recovery within a year of first developing chronic low back pain (35 per cent by 9 months, 41 per cent by one year).

In conclusion, Dr Costa says that this study is important as it demonstrates that the rate of recovery from chronic low back pain is higher than previously reported and that the findings suggest that the prognosis is not uniformly poor for patients with chronic low back pain.

The authors add that the results should be reassuring for patients as they show that recovery from a new episode of chronic non-specific low back pain is possible.

However, in an accompanying editorial, two senior researchers from Keele University point out that, for a condition like low back pain, which for many people lasts a lifetime, research on what happens to patients over much longer time scales is needed.

Only then can we improve our understanding about how different patterns emerge and in what order, why some people recover whereas others have episodic pain for years or develop long term constant pain, they write.