Time to Consider Symptom Duration of 0-2 Weeks as Acute?
Written by Editor   
Wednesday, May 25, 2016 12:00 AM

The purpose of this study was to compare improvement rates in patients with low back pain (LBP) undergoing chiropractic treatment with 0-2 weeks vs 2-4 and 4-12 weeks of symptoms in a prospective cohort outcome study with 1-year follow-up including adult acute (symptoms 0-4 weeks) LBP patients.

The numerical rating scale for pain (NRS) and Oswestry questionnaire were completed at baseline, 1 week, 1 month, and 3 months after starting treatment. The Patient Global Impression of Change (PGIC) scale was completed at all follow-up time points. At 6 months and 1 year, NRS and PGIC data were collected. The proportion of patients reporting relevant “improvement” (PGIC scale) was compared between patients having 0-2 and 2-4 weeks of symptoms.

Patients with 0-2 weeks of symptoms were significantly more likely to “improve” at 1 week, 1 month, and 6 months compared with those with 2-4 weeks of symptoms. Patients with 0-2 weeks of symptoms reported significantly higher NRS and Oswestry change scores at all data collection time points. Outcomes for patients with 2-4 weeks of symptoms were similar to patients having 4-12 weeks of symptoms.

The time period 0-4 weeks as the definition of “acute” should be challenged. Patients with 2-4 weeks of symptoms had outcomes similar to patients with subacute (4-12 weeks) symptoms and not with patients reporting 0-2 weeks of symptoms.

Source: http://www.jmptonline.org/article/S0161-4754(16)00052-X/abstract?elsca1=etoc&elsca2=email&elsca3=0161-4754_201603_39_3_&elsca4=Physical%20Medicine%20and%20Rehabilitation%7CHealth%20Professions