BACK PAIN IN PRIMARY-CARE - OUTCOMES AT 1 YEAR

Outcomes of primary care back pain patients (N = 1128) were studied at 1 year after seeking care. Changes in depression depending on outcome , and predictors of poor outcome were evaluated. Less than one back pa in patient in five reported recent onset (first onset within the previ ous 6 months). One year after seeking care, the large majority of both recent and nonrecent-onset patients reported having back pain in the previous month (69% vs. 82%). A significant minority of both recent an d nonrecent-onset patients had either a poor functional outcome (14% v s. 21%) or continuing high intensity pain without appreciable disabili ty (10% vs. 16%). Predictors of poor outcomes included pain-related di sability, days in pain, lower educational attainment, and female gende r. Among initially dysfunctional patients with persistent pain, one ha lf were improved and one third had a good outcome at the 1-year follow -up. Among initially dysfunctional patients who experienced a good out come, elevated depressive symptoms improved to normal levels at follow -up. The outcome of back pain was predicted by pain-related disability and days in pain rather than by recency of onset, so it may be more m eaningful to distinguish characteristic levels of pain intensity, pain =related disability, and pain persistence than to classify patients as acute or chronic.