Backs get better - don't they?

I often tell some of my more anxious back pain patients that "backs get better". And for the most part this is perfectly true; of course there are people for whom back pain will be ever present and for these people we can only have the greatest sympathy. Long term pain of any kind is a truly awful thing.

Even so, for many, backs do get better and this little nugget of information is often a complete surprise. Back pain is so incredibly common that should I grab the first 100 adults emerging from my local Tescos, 20 of them would be suffering low back pain at that very moment. How many of them would be sneezing with a common cold? It is estimated that over 60% of us have at least one major episode of back pain at some stage during our lives. If we look at it in the light of all this suffering it is self evident that most back trouble does resolve or the majority would be bent double for most of the time.

But perhaps we should be a little more cautious. Patients do not continue to consult their GP, Chiropractor, Physio etc if they feel that the problem has not resolved despite treatment. A study for the BMJ by Croft et al in 1998 about the outcome of GP management for low back pain concluded that,

"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."

Many appear to just simply put up with the discomfort and alter their lives to accommodate it, disillusioned with the care they have received and not confident to seek any more until perhaps their problems are intractable and they become a self fulfilling prophesy.

Maybe then it is not that backs get better - perhaps it is patients who simply stay away.