Prediction of Nonrecovery with Acute Low Back Pain

This particular avenue of communicating might be nice. 

I do not have access to a lot of journals.  Does anyone happen to have access to full text on this particular article?

Authors Grotle, Margreth; Brox, Jens I; Veierod, Merit B; Glomsrod, Bredo; Lonn, Jan H; Vollestad, Nina K

Title Clinical Course and Prognostic Factors in Acute Low Back Pain: Patients Consulting Primary Care for the First Time

Source Spine 30 8:976-982, April 15, 2005



4 responses to “Prediction of Nonrecovery with Acute Low Back Pain

  1. Ben Hando says:

    Selena, I attempted to post the article you requested, but I’m not convinced it worked. Could you let me know if and when you successfully upload the article? Thanks, Ben

  2. Selena Horner says:

    Thanks, Ben. I like this “ask and you will receive” kind of thing. I couldn’t put a comment with the Spine article that you posted though. I could open it up though. Thanks! Selen

  3. David Browder, DPT, OCS says:

    This article is interesting- it makes a striking contrast to the generally accepted (by primary care physicians)rule that most back pain patients get better in 6 weeks without intervention. The study found that (with various interventions – chiro 25%, PT 5%, GP 43%- essentially GP or chiro care) approximately one fourth of the patients who consulted primary care for the first time because of an episode of acute low back pain of < 3 weeks duration had not recovered during 3-month follow-up. There was a mean 53% reduction in pain during the first 3 weeks. Roland disability scores dropped 64% in the first month. Associated with non-recovery was Age > 45 years, current smoking, having 2+ neuro signs, score of 90+ on a psychosocial screening (similar to FABQ).
    A few comments/questions to stimulate discussion:
    Many of the back pain patients that PTs typically see are the 24% that have already failed to improve in this study.
    Question to ponder: If you put a PT (CPR and classification approach in mind) in a primary care position and compared results- would 1) there be a greater/quicker decrease in symptoms? Would less patients fall into the 24% who failed to improve?
    Comment: We need to get into the game- It is telling that even with 24% failing to improve after 6 MONTHS – if I read it correctly the vast majority of these patients still only visited their primary care physician once. Current GP practice has the patient ‘self-recover’ with NSAIDs and advice to stay active for 30 days or so – not exactly encouraging for a return visit. Even if the primary care physician is of a mind to send the Pts that return who did not improve to PT we will still only capture a portion of the patients. We need direct access to this patient population and then we need to show that we can make a difference in time to recovery and decrease chronicity.

  4. John says:

    Point well-taken. As you know, there are projects currently in the works to get at this issue of an immediate care (early intervention) versus stepped care approach (wait-and-see) by matching treatment on both physical and psychosocial characteristics. The data are a few years in front of us, but we can certainly do better (and probably more cost-effecttive) than current standard of care.

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