© 1979 British Society for Rheumatology
research-article |
A PROSPECTIVE STUDY OF LOW BACK PAIN
1Department of Rheumatology, The London Hospital Medical College London E1 2AD
2Division of Medical Computing, Clinical Research Centre Harrow HA1 3UJ
3Academic Department of Psychological Medicine, Institute of Psychiartry Denmark Hill, London SE5 8AF
4Radiodiagnostic Department, The London Hospital London E1 1BB
Correspondence to:
Requests for reprints to Dr. H. L. F. Currey.
Consecutive patients attending hospital for the first time with backache were entered into a prospective study, provided that certain defined causes (infective, neoplastic, metabolic and inflammatory etc.) were not apparent at the first visit. Amongst 188 available for analysis, 65% were discharged and 28% defaulted, together making a total of 93% who ‘recovered uneventfully’ (in the sense that they were no longer attending hospital) on average in about three months, 4% came to ‘myelography’ (radiculography using Dimer-X or Amipaque) including 2% to discectomy, 1.5% proved to have treatable underlying diseases accounting for their backache while 1.5% became ‘qchronic attenders’. Information available at the first visit (patient characteristics, history, examination, radiographs and psychological questionnaire) provided few pointers to what the outcome would be or how long the patient would attend hospital. In particular, routine X-ray examination did not provide clues to any important conditions not already suspected by the clinicians. A case is made for reserving routine radiography for patients who have not recovered within about three months.