The patient with recurrent low back pain

Abstract

Recurrences are part of the natural history of low back pain. In two prospective studies of industrial populations, recurrent symptoms occurred within one year in 60 percent of those workers who had an acute low back pain episode (Bergquist-Ullman and Larsson, 1977; Troup et al., 1981). A history of sciatica has been found to indicate increased risk of recurrence (Troup et al., 1981; Biering-Sorensen, 1983). Biering-Sorensen (1983), in a prospective Danish study found that the risk of recurrent low back pain in the first year increased when there had been (1) many previous back pain episodes, (2) many previous sickness-absence days because of low back pain, (3) short intervals between previous episodes, and (4) an aggravated course of a previous episode. This indicates that the more severe the back problem, the greater the risk of recurrent episodes. Although these studies give some information about the risk of recurrent low back pain, we do not know in an individual patient how great that risk is. Nor do we know precisely how to reduce that risk.