Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Pain. 2013 Aug;154(8):1237-44. doi: 10.1016/j.pain.2013.03.032. Epub 2013 Apr 2.
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 20-67 years 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 12 months 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 1 month 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.
在这项前瞻性队列研究中，我们旨在描述挪威一般人群中急性颈痛和腰痛的自然病程。我们对 9056 名年龄在 20-67 岁之间的受试者进行了筛查，这些受试者在前一个月参加了一项一般健康调查，以了解新的颈痛或腰痛发作情况。筛查确定了 219 名受试者作为本研究的队列。在新疼痛发作后 1、2、3、6 和 12 个月，使用数字评分量表（0-10）报告疼痛强度。描述了颈痛和腰痛、不同基线疼痛水平、年龄组和基线时疼痛部位数量的疼痛病程。描述了药物使用和医疗保健情况，并估计了疼痛强度与寻求医疗保健之间的关联。疼痛在新疼痛发作后 1 个月内迅速减轻，颈痛减轻 0.91（95%置信区间 [CI] 0.50-1.32），腰痛减轻 1.40（95% CI 0.82-1.99），此后变化不大。然而，对于基线时颈痛和腰痛区域疼痛相等的患者和基线时报告有 4 个或更多疼痛部位的患者，疼痛在随访年内保持不变。只有 1/5 的人因疼痛寻求医疗保健。尽管如此，疼痛的病程与干预性研究报告的效果大小相当。因此，本研究为临床试验和实践中疼痛结果的比较提供了自然病程参考数据。
