NATURAL-HISTORY OF LOW-BACK-PAIN - A LONGITUDINAL-STUDY IN NURSES

Study design. Longitudinal study. Objectives. To assess the natural hi story of low back pain. Summary of Background Data. Most episodes of l ow pain resolve or improve within a few weeks, but chronic or recurren t symptoms are common. Previous studies of natural history have usuall y relied on people's long-term recall of symptoms, or they have been l imited to patients seeking clinical care. Methods. Nurses (1,165 women ) completed a base-line questionnaire and up to eight follow-up questi onnaire 3 months apart. Each questionnaire asked whether they had expe rienced low-back pain in the past month. One-month prevalences of pain at specified follow-ups were calculated according to histories of pai n recorded on earlier questionnaires. Results. The 1-month prevalence of low back pain at individual follow-ups ranged from 16% to 19%. Of 9 06 women who completed the base-line questionnaire and at least three follow-up questionnaires, 38 (4.2%) reported pain every time they retu rned a questionnaire, and 190 (21.0%) reported pain on at least three occasions. The presence or absence of low back pain at baseline was hi ghly predictive of future pain throughout follow-up. The longer that b ack pain was consistently reported, the more likely it was to be prese nt at the next follow-ups. Back pain carried a worse prognosis if it w as disabling or associated with sciatica. Conclusions. Our results con firm the importance of back pain duration and the occurrence of associ ated disability and sciatica as predictors of future symptoms, and all ow more reliable quantification of the natural history of back pain in women of working age. In the absence of other information, the differ entials in risk associated with a person's history of back pain appear to remain constant for a period of at least two years.