Ottar Vasseljen
PAIN
Volume 154, Issue 8 , Pages 1237-1244, August 2013
Summary
In subjects who largely refrained from health care treatment, neck and low back pain declined rapidly after a new pain episode, with the exception of some important subgroups.
Abstract
In this prospective cohort study we aimed to describe the natural course of acute neck and low back pain in a general population of Norway. We screened 9056 subjects aged 20–67years who participated in a general health survey for a new episode of neck or low back pain the previous month. The screening identified 219 subjects who formed the cohort for this study. Pain intensity was reported on a numeric rating scale (0–10) at 1, 2, 3, 6, and 12months after start of the new pain episode. The course of pain was described for neck and low back pain, different baseline pain levels, age groups, and number of pain sites at baseline. Use of medication and health care was described and associations between pain intensity and seeking health care were estimated. Pain declined rapidly within 1month after a new pain episode, with a reduction of 0.91 (95% confidence interval [CI] 0.50–1.32) for neck pain and 1.40 (95% CI 0.82–1.99) for low back pain with little change thereafter. However, pain remained unchanged over the follow-up year for those with equal pain in the neck and low back areas at baseline and for those reporting 4 or more pain sites at baseline. Only 1 in 5 sought health care for their complaints. Still, the course of pain was comparable to effect sizes reported in interventional studies. This study thus contributes natural course reference data for comparisons of pain outcome in clinical trials and practice.