Long-term prognosis of acute low back pain in patients seen in general practice: a 1-year prospective follow-up study

Objective. We aimed to examine the prognosis of acute low back pain (LBP) i n patients in general practice and to identify prognostic factors associate d with the long-term prognosis based on information immediately available t o the GP. Method. We conducted a prospective cohort study in general practice in Denm ark. The patients were those aged 18-60 years consulting their GP due to an episode of LBP lasting less than 2 weeks. The GPs collected data regarding 34 exposure variables, including their global assessment of the likelihood of chronic LBP. Outcome variables were collected from the patients after 1 , 6 and 12 months. The outcome measures were days on sick leave, a nd funct ional or complete recovery from LBP. Results. In total, 503 (96%) patients were followed during the whole study period. Fifty per cent of the patients on sick leave returned to work withi n 8 days; after 1 year, only 2% remained on sick leave. At the 1-year follo w-up, 45% of the patients continued to complain of LBP. Logistic regression analyses showed that the factors most significantly associated with poor l ong-term LBP outcome were (i) severity of LBP at inclusion, (ii) assessment s by the GP of susceptibility to develop chronic LBP and (iii) a history of LBP having caused previous sick leave. Conclusions. LBP in general practice has a good prognosis with regard to si ck leave, but a high proportion of patients continue to complain of LBP. We were not able to identify objective measures that strongly predict the pro gnosis of the individual LBP patient. The overall assessment by the GPs see ms to be the most important predictor associated with the long-term outcome .