Low back pain heals the fastest in the first 6 weeks: study

Low back pain is a major cause of disability around the world, affecting more than 570 million people.

Most people who experience severe and sudden back pain begin to improve within the first six weeks, but many will go on to have ongoing pain according to latest Australian research.

The team combined the results of 95 studies looking at the typical course of lower back pain to understand how likely three types of lower back pain are to heal — acute (sudden and severe), persistent and sub-acute (somewhere in between acute and persistent). The researchers suggest those with acute and subacute back pain that does not begin to improve for more than 12 weeks should escalate their care or try a new approach to help avoid developing persistent back pain.

"The good news is that most episodes of back pain recover, and this is the case even if you have already had back pain for a couple of months,” said author Dr Lorimer Moseley, a professor of physiotherapy and pain management at IIMPACT in Health, University of South Australia, Adelaide, Australia.

“The bad news is that once you have had back pain for more than a few months, the chance of recovery is much lower. This reminds us that although nearly everyone experiences back pain, some people do better than others, but we don’t completely understand why,” Moseley said.

“These findings make it clear that back pain can persist even when the initial injury has healed,” Moseley said.

“In these situations, back pain is associated with pain system hypersensitivity, not ongoing back injury. This means that if you have chronic back pain — back pain on most days for more than a few months — then it’s time to take a new approach to getting better.”

He notes that there are new treatments based on training both the brain and body that “focus on first understanding that chronic back pain is not a simple problem, which is why it does not have a simple solution, and then on slowly reducing pain system sensitivity while increasing your function and participation in meaningful activities”.

The authors state that identifying slowed recovery in people with sub-acute low back pain is important so that care can be escalated and the likelihood of persistent pain reduced. Further research into treatments is needed to help address this common and debilitating condition, and to better understand it in people younger than 18 and older than 60 years.

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