Article

OBJECTIVE: To determine the frequency and the characteristics of low back pain
(LBP) recurrences. The research questions were as follows: (1) Are LBP
recurrences common? (2) Do episodes worsen with multiple recurrences? (3) Does
pain change location in any recognizable pattern during an episode? DESIGN:
Single-page self-administered questionnaire. SETTING: Thirty clinical practices
(primary care, physical therapy, chiropractic, and surgical spine) in North
America and Europe. PATIENTS: A convenience sample of 589 respondents with LBP.
There were no exclusions based on type of LBP, history of onset, or
comorbidities. METHODS: The survey was distributed during patients' assessment or
initial treatment at their respective clinics. The survey queried the following:
(1) the severity of original versus most recent episodes based on the following:
pain intensity, interference with leisure and work activities, duration of
episodes, and most distal extent of pain; and (2) changes in pain location within
episodes. RESULTS: In response to research question 1, a previous episode was
reported by 73%; of those, 66.1% reported their first episode lasted </=3 months,
54% reported >/=10 episodes, and 19.4% reported >50 episodes. In response to
research question 2, of those with recurrences, 61.1% reported that at least one
of the survey domains was worse in recent episodes (P < .01) and only 36.9%
reported that they were better; 20.5% were worse in all domains, whereas 8.6%
were better or the same. In response to research question 3, the pain location
changed during the episode in 75.6%; of these, 63.2% reported that their pain
first spread distally before retreating proximally during recovery; there was a
strong trend toward those reporting worsening episodes also reporting
proximal-to-distal-to-proximal changes in pain location during their episodes (r
= 0.132, P < .06). CONCLUSION: Recurrent LBP episodes were common and numerous.
Recurrences often worsened over time. It seems inappropriate to characterize the
typical course of LBP as benign and favorable.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS