A prospective study of patients with acute back and neck pain in Sweden

Background and Purpose. This community-based investigation studied patients with acute back/neck pain and prospectively examined risk factors for chronic pain. Subjects. One hundred twenty residents (64 men, 56 women) of a rural community in Sweden who were off work or had been examined by a physician because of acute low back/neck pain during a 1-year period were randomly selected to participate in the study. Methods. All subjects were examined by a physical therapist and completed questionnaires relating to their functional ability during activities of daily living. The subjects were then prospectively followed to examine treatment content and possible factors for predicting the development of chronic pain. Results. The most common symptom was a dull ache (44%), mostly in the low back (56%). In spite of early care, 16 patients who were randomly selected for further study developed chronic pain during the follow-up year. The patients with chronic pain did not differ from those without chronic pain in age, amount of pain, or handicaps. The risk of developing chronic pain, however, was nearly five times higher for those patients whose pain was provoked by trunk movements in several directions at the first clinical-examination. When signs of possible nerve root affection were present, the risk for chronic pain development was nearly eight times higher. Conclusion and Discussion. These results suggest that more attention may need to be paid to patients with these risk factors, so that effective preventive measures may be developed.