Low Back Pain Prognosis: A Structured Review of the Literature

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It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of
our department: Leadership, Excellence, and Opportunity. The cumulative probability of being pain-
free was 35% (141 events) at nine months and 42% (165 events) at 12 months. Establishing whether
it is the endorsed treatments or their implementation that is the problem could help to improve
outcomes for acute low back pain. The n weighted mean was used in preference to the variance
weighted mean (the usual method of meta-analysis) because several studies did not provide variance
data. Prognosis of chronic low back pain: design of an inception cohort study. Bibliometrics: tracking
research impact by selecting the appropriate metrics. Biopsychosocial determinants of chronic
disability and low-back pain: a review. We gave the practitioners a copy of a clinical practice
guideline for low back pain 16 and asked them to follow it when appropriate. A similar trend was
seen for disability, which decreased by between 33% and 83% of initial levels (pooled mean 58%)
within one month ( 1 ). A superior view of a lumbar vertebra with normal anatomy and canal
configuration is shown in the upper right. Nonpharmacologic Therapies for Low Back Pain: A
Systematic Review for an American College of Physicians Clinical Practice Guideline. The follow-
up rate remained above 97% over the 12 month period. A 2005 prospective, six-week, multicenter,
open label non-randomized pilot study was performed to evaluate efficacy and safety of 5%
lidocaine patch in patients with low back pain in addition to current analgesic therapy. Costa LdCM,
Henschke N, Maher CG, Refshauge KM, Herbert RD, McAuley JH, et al. Subrata Roy GLANDS IN
THE SKIN,FUNCTIONS AND ABNORMALITIES.pptx GLANDS IN THE SKIN,FUNCTIONS
AND ABNORMALITIES.pptx WINCY THIRUMURUGAN USG,CT AND MR IMAGING OF
HEPATIC MASS LESIONS. A randomized, placebo-controlled trial of exercise therapy in patients
with acute low back pain. Hazard et al reported that scores of 0.48 or more on the Vermont disability
prediction questionnaire were associated with a likelihood ratio of 5.7 and scores of less than 0.48
were associated with a likelihood ratio of 0.07. 19 Given the low prevalence of failure to return to
work at three months (pooled estimate of 6%), this predictor may be of limited clinical utility.
Several non-pharmacologic therapies are emerging as contenders for treatment of ALBP in the ED
setting. The aim of this study was to conduct a bibliometric and visualization analysis of low back
pain and to provide a broad view of the current trends in LBP research and a potential guide in this
discipline. Values are numbers (percentages) unless stated otherwise View this table: View popup
View inline Table 2. Data on long term pain and disability were not available. All authors contributed
to the study design and the analysis and interpretation of the data and reviewed and approved the
final version of the manuscript. The association between potential prognostic factors and time to
recovery was modelled with Cox regression. Half of those who reduced their work status at baseline
had returned to previous work status within 14 days (95% confidence interval 11 to 17 days) and
83% had returned to previous work status by three months. Safety was also assessed; no systemic
significant adverse effects were reported, although there were few that experienced mild side
effects.(12). Participants The study sample was a subcohort of an inception cohort of 973
consecutive patients presenting to primary care with acute low back pain ( Main outcome measures
Outcomes and putative predictors measured at initial presentation, onset of chronicity (study entry),
and follow-up at nine and 12 months. LBP is a complicated symptom that has many factors. In
addition we recruited participants using a strict definition for chronic and acute low back pain and
used a clear definition of recovery. 15 Another strength of this study was that we measured the
prognostic markers for the initial acute episode at the time of the episode rather than relying on
recall. Rapid improvements in pain (mean reduction 58% of initial scores), disability (58%), and
return to work (82% of those initially off work) occurred in one month. The prognosis is less
favourable for those who have taken previous sick leave for low back pain, have high disability
levels or high pain intensity at onset of chronic low back pain, have lower education, perceive
themselves as having a high risk of persistent pain, and were born outside Australia.
The largest number of document type was that of articles. The outcomes and costs of care for acute
low-back-pain among patients seen by primary-care practitioners, chiropractors, and orthopedic
surgeons. Expand 63 PDF Save Effectiveness of multifaceted implementation strategies for the
implementation of back and neck pain guidelines in health care: a systematic review A. By keyword
analysis, the research hotspot was biased toward the treatment method from 2000 to 2011, while
research paid more attention to evidence-based medicine from 2012 to 2022. Article types Author
guidelines Editor guidelines Publishing fees Submission checklist Contact editorial office. In one
trial, outcomes were reported only for the whole study sample because at follow up no differences
were found between the groups receiving manual therapy, intensive training, or medical care. 9
Prognostic data from this study are therefore based on the outcomes of the three groups. This
usually occurs in the lateral part of the spinal canal, as shown. Conversely, the number of published
articles increased rapidly after 2008. Work-role of Radiation Therapists in the Consequences of
Adaptive Radiotherap. Discussion The rate of recovery from non-radicular chronic low back pain in
a representative inception cohort from a primary care setting was much higher than previously
reported. 5 6 7 Overall, 35% of patients had recovered completely by nine months and 41% by 12
months. Disability (median recovery time 31 days, 25 to 37 days) and pain (median 58 days, 52 to 63
days) took much longer to resolve. First, the electronic database was limited to Web of Science and
might left out some influential articles. Except for pathological causes of LBP, nonspecific LBP is
ascribed to lifestyle factors, obesity, occupations that require sitting, and depression ( 11 ). Reid et al
20 report proportion returned to work, including those who returned to work and subsequently left
work Download figure. Full results for the univariate Cox regression analyses are on bmj.com.
Cultural variables were not significantly associated with time to recovery. Similar prognostic markers
were associated with delayed recovery from disability (high disability levels or high pain intensity at
presentation for chronic low back pain, greater perceived risk of persistent pain, and being born
outside Australia). Recovery was assessed in terms of return to work, return to function, and
resolution of pain. In order to cover as many target documents as possible, we selected terms that
might be used by most scientific publications to construct a search strategy. Carey TS, Evans A,
Hadler N, Kalsbeek W, McLaughlin C, Fryer J. We censored participants for whom follow-up data
were incomplete or who did not recover from their pain, at the time of their last follow-up. Design
Inception cohort study with one year follow-up. The prognosis is less favourable for those who have
taken previous sick leave for low back pain, have high disability levels or high pain intensity at onset
of chronic low back pain, have lower education, perceive themselves as having a high risk of
persistent pain, and were born outside Australia. Previous sick leave due to low back pain, high
disability levels or high pain intensity at onset of chronicity, low levels of education, greater
perceived risk of persistent pain, and being born outside Australia were associated with delayed
recovery. The review included 21 trials and 30,850 participants. The prognosis of low back pain in
general practice. Subsequent study phase (not shown) tests the impact of predictive model. This
review focuses on emergency department-relevant treatment of this subtype of acute back pain
rather than the treatment of specific etiologies of back pain. Work-role of Radiation Therapists in the
Consequences of Adaptive Radiotherap. Massage A 2015 Cochrane systematic review evaluated the
effects of massage therapy for patients with nonspecific low back pain. If possible, odds ratios with
95% confidence intervals were extracted or calculated from the data.
Rapid improvements in pain (mean reduction 58% of initial scores), disability (58%), and return to
work (82% of those initially off work) occurred in one month. Asian countries participated in the
publication of articles with a relatively low number. Of the six studies, one (17%) 19 20 used blinded
assessment and four (67%) 13 14 27 28 performed statistical adjustment for prognostic factors. The
cumulative probability of being pain-free was 39.9% by six weeks, 58.2% by 12 weeks, and 72.5%
by one year. See bmj.com for further details. Letter to the editor regarding analysis of changing
paradigms of management in 179 patients with spinal tuberculosis during a 12-year period and
proposal of a new management algorithm. Maher and Rachelle Buchbinder and Jan Hartvigsen and
Martin Underwood and Maurits W. GERIATRIC PHARMACOLOGY Geriatric pharmacology is a
specialized field focusing. A systematic review and meta-synthesis of the impact of low back pain on
people’s lives. Spondylolisthesis refers to the anterior displacement of a vertebra on the one beneath
it. Funding: This study was supported by a grant from the National Health and Medical Research
Council of Australia. Altman DG, Lausen B, Sauerbrei W, Schumacher M. When participants
reported sustaining one of these outcomes for 30 consecutive days we considered them as
“recovered” in that dimension on the first of the 30 days. 15 A more stringent measure of
recovery—complete recovery—required the patient to recover on all three of the pain, disability, and
work status outcomes. Discussion The rate of recovery from non-radicular chronic low back pain in
a representative inception cohort from a primary care setting was much higher than previously
reported. 5 6 7 Overall, 35% of patients had recovered completely by nine months and 41% by 12
months. Recovery was assessed in terms of return to work, return to function, and resolution of pain.
Journals related to etiology and treatment of LBP stand out. Furthermore, we used CiteSpace 5.8.3
to analyze strongest citation bursts. For those who do present to the emergency department, one US
study found that 81% of episodes of LBP began at home with lifting representing the most common
inciting event.(7) Prevention There is minimal formal literature on the effectiveness of preventive
measures such as braces, ergonomic furniture, and lifting assistance devices.(3) One 2016 JAMA
systematic review evaluated preventive measures for low back pain. Moreover, we screened titles
and abstracts in relation to inclusion and exclusion criteria. The concentration of research has
contributed to alleviation of long-term suffering from LBP and reduction in medical economic
burden. No significant events were reported in the reviewed randomized control trials but minor,
short-duration events including headache, stiffness, and transiently-increased pain occurred.(31) Of
note, cervical manipulation therapy does carry a risk of vertebral artery dissection, and thus, if
included in the manipulation therapy session, is not an entirely benign treatment. Subsequent study
phase (not shown) tests the causal relationship between prognostic factor and outcome. 3. Outcome
prediction (Risk group) studies develop models to identify risk groups. Several characteristics of low
back pain make consideration of prognosis extremely important. LBP is a complicated symptom that
has many factors. Parenteral corticosteroids for Emergency Department patients with non-radicular
low back pain. Our data show that study participants had rapid improvements in pain and disability
within one month. Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap.
Patients with high disability levels or high pain intensity at presentation for chronic low back pain,
previous sick leave due to low back pain, a lower level of education, and greater perceived risk of
persistent pain were more likely to experience delayed recovery from pain than those without these
characteristics. There are 10 clusters in the main field of LBP ( Figure 6 ). We excluded patients with
a diagnosis of radiculopathy or serious spinal disease, such as cancer, spinal infection, spinal fracture,
and inflammatory arthritis. Maffulli Medicine BMC Musculoskeletal Disorders 2023 TLDR An
evidence-based overview of the principles of pharmacological management of NCLPB is provided
and it is important to identify patients with generalized sensory hypersensitivity, who may benefit
from dedicated therapy.
Anema and Daniel C. Cherkin and Roger Chou and Steven P. We identified seven factors associated
with poor prognosis that could be readily applied in primary care. Schiottz-Christensen B, Nielsen
GL, Hansen VK, Schodt T, Sorensen HT, Olesen F. Survival curves were constructed on the basis of
the dates participants returned to work in their previous capacity, had no disability, or were free of
pain. Systematic reviews of evaluations of prognostic variables. Participants with high disability
levels or high pain intensity at presentation for chronic low back pain, higher perceived risk of
persistent pain, and who were born outside Australia were more likely to have delayed recovery from
their disability. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at
the Allen Institute for AI. RESULTS: The follow-up rate over the 12 months was more than 97%.
The association between potential prognostic factors and time to recovery was modelled with Cox
regression. Expand 1 PDF Save NON-SPECIFIC BACK PAIN: DIAGNOSIS AND THERAPY
FROM THE POSITION OF EVIDENTIAL MEDICINE (REVIEW OF LITERATURE) S. Costa
LdCM, Henschke N, Maher CG, Refshauge KM, Herbert RD, McAuley JH, et al. The adjusted
hazard ratio for participants born outside Australia was 0.51 (95% confidence interval 0.33 to 0.78).
Therefore participants who were born outside Australia were 49% less likely at some time in the
future to recover from disability than those who were born in Australia. It is a crucible, a test of
knowledge and strength, and a true manifestation of the tripartite mission of our department:
Leadership, Excellence, and Opportunity. We selected specific markers considered to be associated
with a poor outcome (see web extra on bmj.com). The markers were measures of sociodemographic
characteristics, general health, current and previous low back pain, red flag symptoms or signs
(features thought to be associated with serious spinal disease), pain intensity, disability, and
psychological characteristics. Ibuprofen Plus Acetaminophen Versus Ibuprofen Alone for Acute Low
Back Pain: An Emergency Department-based Randomized Study. Dangers of using “optimal”
cutpoints in the evaluation of prognostic factors. Report Back from San Antonio Breast Cancer
Symposium (SABCS) 2023: Spotlight. We identified seven readily assessed factors that were
associated with speed of recovery and can be considered by clinicians when advising their patients
about the prognosis for their episode of acute low back pain. The concentration of research has
contributed to alleviation of long-term suffering from LBP and reduction in medical economic
burden. Figure 5A presents the 20 most productive authors in LBP research. MAIN OUTCOME
MEASURES: Participants completed a baseline questionnaire and were contacted six weeks, three
months, and 12 months after the initial consultation. Recent advances in pain neuroscience applied in
the intervention for low back pain. Seferlis T, Nemeth G, Carlsson AM, Gillstrom P. This indicates
that the primary impediment to complete recovery is ongoing pain. At the onset of chronicity the
cohort had relatively low levels of pain and disability—for example, around two thirds reported pain
levels as “mild” or less and disability levels as a “little bit” or less. Our secondary aim was to identify
prognostic markers at the onset of chronicity. Any product that may be evaluated in this article, or
claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Koes
BW, van Tulder MW, Ostelo R, Kim Burton A, Waddell G. SETTING: Primary care clinics in
Sydney, Australia. Comparison of intravenous NSAIDs and trigger point injection for low back pain
in ED: A prospective randomized study.
RESULTS: The follow-up rate over the 12 months was more than 97%. All but one study quantified
prognosis. 18 Six studies reported prognostic factors. In addition, the retrieve algorithm of WOS was
not based on full text; therefore, a few relevant articles may have been missed and some irrelevant
articles may have been included, which may have led to some bias for the visualization of LBP. The
prognosis of low back pain in general practice. Seferlis T, Nemeth G, Carlsson AM, Gillstrom P.
Completeness of follow-up was 97% of person time. 18 Table 1 ? shows the baseline characteristics
of the study population. The cohort will be followed up by telephone at baseline, 9 months and 12
months after being diagnosed with chronic low back pain. CONCLUSIONS: In this cohort of
patients with acute low back pain in primary care, prognosis was not as favourable as claimed in
clinical practice guidelines. We used Cox regression to identify the independent associations between
the seven factors and the time to complete recovery from acute low back pain. The return to work
outcome was irrelevant for participants who were not seeking work—for example, retirees. At 12
months the participants’ responses to the question “If you had to live with the symptoms you have
right now, how would you feel about it?” were generally positive, though 133 of the 969 participants
reported feeling very dissatisfied and 106 somewhat dissatisfied. Completeness of follow-up was
calculated using the completeness index. 18 This index is the ratio of the total observed person time
of follow-up as a percentage of the potential time of follow-up in a study. Prevention of Low Back
Pain: A Systematic Review and Meta-analysis. The adjusted hazard ratio for previous sick leave due
to low back pain was 0.69 (95% confidence interval 0.50 to 0.97) and for low level of education was
0.74 (0.54 to 1.00). Therefore participants who had taken previous sick leave due to low back pain
and those with no education beyond secondary school were 31% and 26%, respectively, less likely
to recover from pain at any time in the future compared with those without these characteristics.
Among those presenting for care, there is variability in outcome according to patient characteristics.
Therefore, there has long been attention on prognosis research in the field. A 2013 Cochrane review
evaluated the literature for assessment of therapeutic benefit of traction for low back pain and
demonstrated no little or no difference in pain intensity between traction and sham treatment. This
information is, however, new and needs to be validated in future studies. The aim of this study was
to conduct a bibliometric and visualization analysis of low back pain and to provide a broad view of
the current trends in LBP research and a potential guide in this discipline. All authors contributed to
the study design and the analysis and interpretation of the data and reviewed and approved the final
version of the manuscript. Nine total trials were analyzed including 1,117 participants. Peripheral
Vascular Disease (PVD): Physiotherapy assessment and management Peripheral Vascular Disease
(PVD): Physiotherapy assessment and management Different Export Prices of Medicinal Drugs.pdf
Different Export Prices of Medicinal Drugs.pdf TRANSPORT PROCESS ACROSS CELL
MEMBRANE.pptx TRANSPORT PROCESS ACROSS CELL MEMBRANE.pptx Expectorants
and Antitussives.pdf Expectorants and Antitussives.pdf Approach to low back pain 1. Shipton
Medicine Pain and Therapy 2018 TLDR In chronic low back pain, the physical therapy exercise
approach remains a first-line treatment, and should routinely be used. Such a bibliometric analysis on
LBP related to data analysis has never been performed previously. Prednisone for emergency
department low back pain: a randomized controlled trial. Participating practitioners were trained to
identify all eligible patients presenting at their clinics from November 2003 to July 2005. The
cumulative probability of complete recovery was 35% (139 events) at nine months and 41% (163
events) at 12 months (fig 2). Effect of an early intervention program on the relationship between
subjective pain and disability measures in nurses with low back injury. Maher and Rachelle
Buchbinder and Jan Hartvigsen and Martin Underwood and Maurits W. Early prediction of chronic
disability after occupational low back injury.