Croft P R, Macfarlane G J, Papageorgiou A C, Thomas E, Silman A J
University of Keele, School of Postgraduate Medicine, Industrial and Community Health Research Centre, Hartshill, Stoke on Trent ST4 7QB.
BMJ. 1998 May 2;316(7141):1356-9. doi: 10.1136/bmj.316.7141.1356.
To investigate the claim that 90% of episodes of low back pain that present to general practice have resolved within one month.
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.
Two general practices in south Manchester. 490 subjects (203 men, 287 women) aged 18-75 years.
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.
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.
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.
调查关于在全科医疗中出现的腰痛病例90%在一个月内已痊愈的说法。
对因腰痛在12个月内到全科医疗就诊的所有成年人进行前瞻性研究,在就诊后1周、3个月和12个月进行随访。
曼彻斯特南部的两家全科医疗诊所。490名年龄在18 - 75岁之间的受试者(203名男性,287名女性)。
3个月后不再因腰痛就诊的患者比例;3个月和12个月时无疼痛及与背部相关残疾的患者比例。
诊所内成年人的年累计就诊率为6.4%。在463例新发腰痛就诊患者中,275例(59%)仅就诊一次,150例(32%)的复诊仅限于初次就诊后的3个月内。然而,在3个月和12个月随访时接受访谈的患者中,分别只有39/188(21%)和42/170(25%)在疼痛和残疾方面完全康复。
结果符合以下解释,即基层医疗中90%的腰痛患者在三个月内将停止因症状就诊。然而,大多数患者在就诊一年后仍会经历腰痛及相关残疾。