What is the prognosis of mechanical low back pain?

Updated: Mar 30, 2020
  • Author: Everett C Hills, MD, MS; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

The prognosis is good for recovery from mechanical low back pain (LBP). At 1 month, 35% of patients can be expected to recover; at 3 months, 85% have recovered; and at 6 months, 95% have recovered.

Failure of a patient to recover should lead the clinician into a more thorough and extensive search into the cause of the back pain, including the possibility of recurrent back injuries.

Recurrence at 1 year is 62%. At 2 years, 80% of patients have had 1 or more recurrences. The question remains whether this is the inevitable result of natural aging, continued pathologic processes, somatization, or a combination of all of these. Clearly, much more research is required.

A prospective cohort study by Mehling et al reviewed outcome measures for recovery in primary-care patients with recent-onset acute LBP. Since a consensus does not exist about outcome definitions or how to identify when patients have failed to recover from an episode of LBP, the authors suggest that a combination of ratings from perceived recovery scales along with pain and disability measures be used as a highly accurate way to identify recovery. [41]

A study by Imagama et al indicated that in patients with chronic LBP, factors that negatively impact the outcome of pharmacologic therapy for the condition include neuropathic pain at baseline, Tramacet use at baseline, use of weak opioids at baseline, older age, lengthy disease duration, a history of spinal surgery, and smoking. [42]


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