Self-Care First LLC, Hanover, NH, USA.
PM R. 2012 Jun;4(6):394-401; quiz 400. doi: 10.1016/j.pmrj.2011.10.015. Epub 2012 Mar 3.
To determine the frequency and the characteristics of low back pain (LBP) recurrences. The research questions were as follows: (1) Are LBP recurrences common? (2) Do episodes worsen with multiple recurrences? (3) Does pain change location in any recognizable pattern during an episode?
Single-page self-administered questionnaire.
Thirty clinical practices (primary care, physical therapy, chiropractic, and surgical spine) in North America and Europe.
A convenience sample of 589 respondents with LBP. There were no exclusions based on type of LBP, history of onset, or comorbidities.
The survey was distributed during patients' assessment or initial treatment at their respective clinics. The survey queried the following: (1) the severity of original versus most recent episodes based on the following: pain intensity, interference with leisure and work activities, duration of episodes, and most distal extent of pain; and (2) changes in pain location within episodes.
In response to research question 1, a previous episode was reported by 73%; of those, 66.1% reported their first episode lasted ≤3 months, 54% reported ≥10 episodes, and 19.4% reported >50 episodes. In response to research question 2, of those with recurrences, 61.1% reported that at least one of the survey domains was worse in recent episodes (P < .01) and only 36.9% reported that they were better; 20.5% were worse in all domains, whereas 8.6% were better or the same. In response to research question 3, the pain location changed during the episode in 75.6%; of these, 63.2% reported that their pain first spread distally before retreating proximally during recovery; there was a strong trend toward those reporting worsening episodes also reporting proximal-to-distal-to-proximal changes in pain location during their episodes (r = 0.132, P < .06).
Recurrent LBP episodes were common and numerous. Recurrences often worsened over time. It seems inappropriate to characterize the typical course of LBP as benign and favorable.
确定腰痛（LBP）复发的频率和特征。研究问题如下：（1）LBP 复发是否常见？（2）随着多次复发，病情是否恶化？（3）在发作过程中，疼痛是否会以任何可识别的模式改变位置？
单页自我管理问卷。
北美和欧洲的 30 个临床实践（初级保健、物理治疗、脊椎按摩和脊柱外科）。
589 名有 LBP 病史的患者作为方便样本。没有根据 LBP 的类型、发病史或合并症排除任何患者。
该调查在患者各自诊所的评估或初始治疗期间进行。该调查询问了以下内容：（1）根据以下内容比较原始和最近发作的严重程度：疼痛强度、休闲和工作活动的干扰、发作持续时间和疼痛的最远端范围；以及（2）发作过程中疼痛位置的变化。
为回答研究问题 1，73%的患者报告有既往发作史；其中，66.1%的患者报告首次发作持续时间≤3 个月，54%的患者报告发作次数≥10 次，19.4%的患者报告发作次数>50 次。为回答研究问题 2，对于有复发的患者，61.1%报告至少有一个调查领域在最近的发作中更差（P<.01），只有 36.9%报告情况更好；20.5%在所有领域都更差，而 8.6%情况更好或相同。为回答研究问题 3，75.6%的患者报告疼痛位置在发作过程中发生了变化；其中，63.2%的患者报告疼痛首先向远端扩散，然后在恢复过程中向近端退缩；报告发作恶化的患者在发作过程中报告疼痛位置近端至远端至近端变化的比例也有明显增加的趋势（r=0.132，P<.06）。
复发性 LBP 发作很常见，且数量众多。随着时间的推移，复发往往会恶化。将典型的 LBP 病程描述为良性和有利似乎并不合适。
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