Prognosis of low back pain in primary care

doi:10.1136/bmj.b3694

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Elaine M Hay, professor of community rheumatology 1,
Kate M Dunn, senior lecturer in epidemiology 1

¹Arthritis Research Campaign National Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire ST5 5BG

e.m.hay{at}keele.ac.uk

Research on what happens to patients with back pain over much longer time scales is needed

Several studies have described the epidemiology of acute and chronic low back pain using different inclusion criteria, follow-up points, definitions of prognostic indicators, and outcomes. In the linked study Costa and colleagues (doi: 10.1136/bmj.b3829) report the course of chronic low back pain in 406 patients who presented to primary care with back pain for more than three months.1 A similar study published in the BMJ reported the prognosis of acute back pain in primary care.2

These studies differ from much previous research on back pain because they identify “incident” cases consulting in primary care. These cases are intended to provide an inception cohort, which is considered to be the gold standard for cohort studies. The two studies have a high follow-up rate, and so they can report the proportion of patients with back pain who completely recover 12 months after an index consultation—72% for the acute cohort …