Acute Back Pain with Serious Pathology Is Rare in Primary Care, Study Says

Roughly 1% of Back Pain Patients Have a Significant Underlying Cause of Their Acute Pain

Few patients who visit a primary care physician about acute back pain have a serious underlying pathology, according to a study detailed in January’s Journal of the American Academy of Physician Assistants (JAAPA).

In this study, researchers surveyed approximately 1,172 acute back pain patients on the possible presence of 25 red flags, or symptoms, associated with serious back pain causes like cancer, cauda equina syndrome, spinal fractures or infection.

Based on these discussions, the patients were categorized into one of three groups: simple backache, compromised nerve root or suspected spinal pathology.

The researchers then followed up with these patients at 6 weeks, 3 months and 12 months after the initial consultation with the primary care physician. Furthermore, a rheumatologist randomly and independently evaluated 20% of the nearly 1,200 patients to assess whether a serious pathology was the cause of back pain.

According to the study’s findings, while at least 1 red flag was reported in 80% of the patients with acute back pain who sought primary care, a serious pathology was confirmed in only 1% of the patients.

Of the pathologies to cause back pain, fractures were most common. Spinal cancer or infection was not present in any of the patients.

This study ultimately confirms the important point about how a majority of episodes of acute lower back pain are due to general causes like muscle strains, which can seem minor on the surface but cause severe pain.

Patients with acute back pain caused by a muscle strain or ligament sprain may consider various non-surgical treatments like pain medications, ice/heat therapy and/or exercise to relieve their symptoms.

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