ArticleSpine2012
The prognosis of acute low back pain in primary care in the United States: a 2-year prospective cohort study.
Article in Spine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Are combined conservative interventions effective in reducing pain, disability and/or global rating of pain in people with sciatica with known neuropathic pain mechanisms?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Pooled it
- The clinical course of acute, subacute and persistent low back pain: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Pooled it
- Sustained acoustic medicine treatment of discogenic chronic low back pain: A randomized, multisite, double-blind, placebo-controlled trial.Journal of back and musculoskeletal rehabilitation · 2024Trial
- Physical Therapy Referral From Primary Care for Acute Back Pain With Sciatica : A Randomized Controlled Trial.Annals of internal medicine · 2021Trial
- Prognostic indicators for poor outcomes in low back pain patients consulted in primary care.PloS one · 2020Trial
- Outcomes of Patients With Acute Low Back Pain Stratified by the STarT Back Screening Tool: Secondary Analysis of a Randomized Trial.Physical therapy · 2017Trial
- Physiotherapy informed by acceptance and commitment therapy for chronic low back pain: A randomized trial.Hong Kong physiotherapy journal : official publication of the Hong Kong Physiotherapy Association Limited = Wu li chih liao · 2026Article
- [When nothing helps anymore outside: interdisciplinary multimodal pain therapy].Orthopadie (Heidelberg, Germany) · 2025Article
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- The Role of Back Muscle Dysfunctions in Chronic Low Back Pain: State-of-the-Art and Clinical Implications.Journal of clinical medicine · 2023Article
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- Definitions of Chronic Low Back Pain From a Scoping Review, and Analyses of Narratives and Self-Reported Health of Adults With Low Back Pain.The journal of pain · 2023Article
- Learning from addiction: Craving of prescription opioids in chronic pain sufferers.Neuroscience and biobehavioral reviews · 2022Review
- [Back pain: a phenomenon of age? : Degenerative alterations of the spine are normal with increasing age. But how is this "normal" in old age defined, does it compulsorily lead to more complaints and a relevant impairment of the quality of life?]Zeitschrift fur Gerontologie und Geriatrie · 2022Article
- Neurophysiological and transcriptomic predictors of chronic low back pain: Study protocol for a longitudinal inception cohort study.Research in nursing & health · 2022Article
- Digital Rehabilitation for Acute Low Back Pain: A Prospective Longitudinal Cohort Study.Journal of pain research · 2022Article
- Prediction and trend of tactile acuity, pain and disability in acute LBP: a six-month prospective cohort study.BMC musculoskeletal disorders · 2021Article
- Stratified care to prevent chronic low back pain in high-risk patients: The TARGET trial. A multi-site pragmatic cluster randomized trial.EClinicalMedicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
STUDY
designProspective cohort study.
objectiveTo assess the prognosis of patients presenting with acute low back pain (LBP) in a primary care setting in the United States. SUMMARY OF BACKGROUND DATA: Practice guidelines for acute LBP based on return-to-work outcomes underestimate the development of chronic pain in the primary care setting. Because of differences in inclusion criteria, chronic pain definitions, and national health systems, prognostic cohort studies have reported a wide range of results limiting interpretation and generalization. Current data from carefully designed prognostic studies of acute LBP are lacking for the US primary care system.
methodsMembers of a large health service organization were enrolled after seeking medical care for acute LBP, with or without sciatica, of up to 30 days duration, with no episode in the past 12 months and no history of spine surgery. We conducted phone interviews at baseline, 6 months, and 2 years. Based on receiver operating characteristic analyses, a combination of global perceived recovery with pain intensity was used as primary outcome for chronic pain. Recurrence and multiple secondary outcomes were assessed to allow for comparison with other studies.
resultsSix hundred five patients had an average pain intensity of 5.6 (numeric rating scale = 0-10) and disability of 15.8 (Roland-Morris scale = 0-24). Eight percent had declared sick leave between pain onset and baseline interview. Thirteen percent of 521 patients (86% follow-up) experienced chronic pain at 6 months and 19% of 443 patients at 2 years. At 6 months, 54% had experienced at least 1 LBP recurrence, and 47% in the subsequent 18 months.
conclusionThe prognosis of strictly defined acute LBP, with or without sciatica, is less favorable than commonly stated in practice guidelines based on failure to return to work. Broad initiatives to develop new means for the primary and secondary prevention of recurrent and chronic LBP are urgently needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.