DEIRDRE HURLEY wrote:
> 
> which article are you referring to ?
> 
> deirdre hurley

I had sent the whole article as an attachement but it was returned as it
was too big.  Here is the abstract and references for the full article. 
Ross.

BMJ VOLUME 316 2 MAY 1998
 www. bmj.com
Outcome of low back pain in general practice:
a prospective study
Peter R Croft, Gary J Macfarlane, Ann C Papageorgiou, Elaine Thomas,
Alan J Silman

Abstract
Objectives: To investigate the claim that 90% of
episodes of low back pain that present to general
practice have resolved within one month.

Design: Prospective study of all adults consulting in
general practice because of low back pain over
12 months with follow up at 1 week, 3 months, and
12 months after consultation.

Setting: Two general practices in south Manchester.
Subjects: 490 subjects (203 men, 287 women) aged
18­75 years.

Main outcome measures: Proportion of patients who
have ceased to consult with low back pain after
3 months; proportion of patients who are free of pain
and back related disability at 3 and 12 months.

Results: Annual cumulative consultation rate among
adults in the practices was 6.4%. Of the 463 patients
who consulted with a new episode of low back pain,
275 (59%) had only a single consultation, and
150 (32%) had repeat consultations confined to the
3 months after initial consultation. However, of those
interviewed at 3 and 12 months follow up, only 39/188
(21%) and 42/170 (25%) respectively had completely
recovered in terms of pain and disability.
Conclusions: The results are consistent with the
interpretation that 90% of patients with low back pain
in primary care will have stopped consulting with
symptoms within three months. However most will
still be experiencing low back pain and related
disability one year after consultation.
observations with the notion that most patients seen in
primary care are completely better within a month.
We investigated the claim that 90% of episodes
resolve within a month by determining the outcome of
unselected episodes of low back pain in general
practice. The two outcomes evaluated were the
proportion of patients who ceased to consult about the
problem three months later and the proportion of
patients who were free of pain and back related disabil­
ity after three and 12 months.

Subjects and methods
The study population consisted of all patients aged
18­75 years in two general practices in south
Manchester who consulted their general practitioner
about low back pain at least once in a 12 month period.
In both practices doctors routinely recorded each
consultation on computer, enabling us to identify all
patients with low back pain recorded as a reason for
consultation. We obtained ethical approval from the
local health authority.

We defined the first consultation for low back pain
by any patient during the 12 months as the “index”
consultation. This was not necessarily the patient's first
consultation in an episode of back pain. All those who
had not visited their general practitioner because of
low back pain in the three months before this index
consultation were defined as experiencing a “new con­
sulting episode” of low back pain. 

University of Keele,
School of
Postgraduate
Medicine, Industrial
and Community
Health Research
Centre, Hartshill,
Stoke on Trent
ST4 7QB
Peter R Croft,
professor
ARC Epidemiology
Research Unit,
School of
Epidemiology and
Health Sciences,
University of
Manchester,
Stopford Building,
Manchester
M13 9PT
Gary J Macfarlane,
senior lecturer
Ann C
Papageorgiou,
studies coordinator
Elaine Thomas,
research statistician
Alan J Silman,
director
Correspondence to:
Dr Macfarlane
G.Macfarlane@
man.ac.uk
BMJ 1998;316:1356–9


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