Von Korff M, Saunders K
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington, USA.
Spine (Phila Pa 1976). 1996 Dec 15;21(24):2833-7; discussion 2838-9. doi: 10.1097/00007632-199612150-00004.
Review paper of outcome studies among primary care back pain patients.
To determine the short-term and long-term pain and functional outcomes of patients with back pain who are seeking treatment in primary care settings.
Back pain has been viewed as running either an acute or a chronic course, but most patients experience recurrent back pain. This review summarizes outcome studies in light of the episodic course of back pain.
Studies reporting pain and functional outcome data for consecutive primary care patients with back pain were reviewed.
Back pain among primary care patients typically is a recurrent condition for which definitions of acute and chronic pain based on a single episode are inadequate. Because a majority of patients experience recurrences, describing only the outcome of the initial back pain episode may convey a more favorable picture of long-term outcome than warranted. For the short-term follow-up evaluation, most patients improve considerably during the first 4 weeks after seeking treatment. Sixty-six percent to 75% continue to experience at least mild back pain 1 month after seeking care. At 1 month, approximately 33% report continuing pain of at least moderate intensity, whereas 20-25% report substantial activity limitations. For the long-term follow-up (1 year or more) period, approximately 33% report intermittent or persistent pain of at least moderate intensity, one in seven continue to report back pain of severe intensity, and one in five report substantial activity limitations.
Results from existing studies suggest that back pain among primary care patients typically runs a recurrent course characterized by variation and change, rather than an acute, self-limiting course.
对基层医疗背痛患者结局研究的综述论文。
确定在基层医疗机构寻求治疗的背痛患者的短期和长期疼痛及功能结局。
背痛一直被视为要么是急性病程，要么是慢性病程，但大多数患者经历复发性背痛。本综述根据背痛的发作性病程总结结局研究。
对报告连续基层医疗背痛患者疼痛和功能结局数据的研究进行综述。
基层医疗患者的背痛通常是一种复发性疾病，基于单次发作定义急性和慢性疼痛是不够的。由于大多数患者会复发，仅描述初始背痛发作的结局可能会比实际情况更乐观地传达长期结局。对于短期随访评估，大多数患者在寻求治疗后的前4周内有显著改善。66%至75%的患者在寻求治疗1个月后仍至少经历轻度背痛。在1个月时，约33%的患者报告持续至少中度强度的疼痛，而20 - 25%的患者报告有严重的活动受限。对于长期随访（1年或更长时间），约33%的患者报告间歇性或持续性至少中度强度的疼痛，七分之一的患者继续报告严重强度的背痛，五分之一的患者报告有严重的活动受限。
现有研究结果表明，基层医疗患者的背痛通常呈复发性病程，其特点是变化和改变，而非急性、自限性病程。
