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Hansson, Tommy1; Olaya‐Contreras, Patricia1; Holm, Allison Kaigle1; Olsson, Marita2; Styf, Jorma1
1Sahlgrenska Academy, Department of Orthopaedics, Gothenburg, Sweden;2Chalmers University of Technology, Department of Mathematical Sciences, Gothenburg, Sweden
INTRODUCTION: Episodes of acute low back pain (LBP) are extremely common. Staying active in spite of the pain has been regarded as the most appropriate treatment recommendation. The objective of this study was to evaluate if this “stay active in spite of the pain” advice was more effective in helping to reduce pain and disability than the advice “adjust your activity according to the pain” in subjects with severe acute LBP.
METHODS: One hundred‐and‐nine employed subjects with severe acute LBP were recruited consecutively and examined within 48 hours of debut. They were randomly given one of the two treatment recommendations, i.e. “stay active in spite of the pain” or “adjust your activity according to the pain” and then followed for 1 week using the following measures: Disability Rating Index, pain intensity, and step count (pedometer).
RESULTS: At baseline, there were no differences between the groups with regard to cause of pain, occupation, pain intensity, disability, quality of life or fear of movement. The acute LBP onset occurred at work in 31% of the subjects and 34% of all the subjects had no explanation for the LBP. Disability and pain intensity decreased rapidly and at similar rates (p< 0.001) in both groups. The “stay active” group had a greater step count across time.
DISCUSSION: The treatment recommendations “stay active in spite of pain” or “adjust your activity according to the pain” did not have different effects on the firstweek course of acute LBP with regard to pain reduction or disability.
© 2011 Lippincott Williams & Wilkins, Inc.
| This study indicates that an intervention is necessary to circumvent an episode of acute low back pain. If patients do nothing to improve or restore the spinal biomechanics and to decrease pain, little progress is made during the first week. A substantial portion of our acute low back pain patients get back to a normal activity level of within 48 hours. | | Dr Jocelyn Sicotte. D.C | www.drsicotte.com | www.herniediscale.ca |
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