What is the prognosis for mechanical back pain?

Updated: Aug 27, 2020
  • Author: Debra G Perina, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Answer

The prognosis is good for most patients who present with mechanical back pain. [16, 17]  Overall, 70% of patients feel better in 1 week; 80%, in 2 weeks; and 90%, in 1 month. Only 10% of all patients with low back pain have long-term problems.

A significant functional overlay or component of secondary gain is present in a subgroup of patients, who also account for the majority of office visits with low back pain complaints (see Causes section).

Recurrence is common and seen in up to 40% of patients within 6 months. Prevention methods should be discussed with patients with low back pain along with encouragement to monitor them when the acute period has resolved.

Psychosocial factors such as presence of posttraumatic stress disorder, use of a lawyer, presence of other chronic illnesses, and lower education levels appear to be positive predictors of development of chronic back pain in patients who sustain an initial injury to their back. Chronic back pain development was not associated with age, gender, occupation, or severity of original injury. [43]

A systematic review by Chou and Shekelle found that the following factors were most helpful for predicting which patients would experience persistent disabling low back pain: maladaptive pain coping behaviors, nonorganic signs, functional impairment, general health status, and presence of psychiatric comorbidities. Factors related to the patient's work environment, baseline pain, and presence of radiculopathy are less useful for predicting worse outcomes. [18]


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