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Initial Assessment Methods
(Adapted from AHCPR 1994)
X-Rays
Psychosocial Factors
Risk factors for chronicity
Management
Information to Patients
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Information to Patients
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Appropriate information and
advice can reduce anxiety and improve patient satisfaction with care.
Deyo & Diehl 1986, Jones et al 1988, Roland
& Dixon 1989, AHCPR 1994
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Evidence exists in support of the following statements:
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Most severe back pain and
severe activity limitation improves considerably in a few days or at most
a few weeks, but milder symptoms may persist longer, often for a few
months. |
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Most patients will have some
recurrences of back pain from time to time.
(« Recurrences are normal
and do not mean that you have re-injured your back or that your condition
is getting worse.) |
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About 10% of patients will
have some persisting symptoms a year later, but most of them can manage to
continue with most normal activities. Patients who return to normal
activities feel healthier, use less analgesics and are less distressed
than those who limit their activities.
Pedersen 1981, Troup et al 1981 and Lloyd
& Troup 1983 (same study), Roland & Morris 1983 and Roland et al
1983 (same study), Chavannes et al 1986, Coste et al 1994, Von Korff et al
1993, Von Korff & Saunders 1996
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The longer someone is off work
with back pain, the lower their chance of returning to work.
McGill 1968, Abenhaim et al 1985, Waddell 1987.
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Back pain does not usually
increase with age, but becomes (slightly) less common after age 50-60.
However, older patients who do continue to have back pain may have more
persistent symptoms and more activity limitation.
CSAG 1994b
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