title: Exploring the Definition of Acute Low Back Pain: A Prospective Observational Cohort Study Comparing Outcomes of Chiropractic Patients With 0-2, 2-4, and 4-12 Weeks of Symptoms.
abstract: 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.
  
  
  
  This was 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 using the χ(2) test at all data collection time points. The unpaired t test compared NRS and Oswestry change scores between these 2 groups.
  
  
  
  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 (P < .015). 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.
authors.affiliation: Chiropractic Medicine Doctoral Student, Chiropractic Medicine Department, Faculty of Medicine, University of Zürich, Switzerland.
authors.forename: Karin E
authors.initials: KE
authors.lastname: Mantel
authors.affiliation: Professor, Orthopedic University Hospital Balgrist, Departments of Chiropractic Medicine and Radiology, Orthopedic University Hospital Balgrist, University of Zürich, Switzerland. Electronic address: xraydcpeterson@yahoo.ca.
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Peterson
authors.affiliation: Professor, University of Zürich, Department of Chiropractic Medicine, Faculty of Medicine, University of Zürich, Switzerland.
authors.forename: B Kim
authors.initials: BK
authors.lastname: Humphreys
mesh_terms: D059787:Acute Pain / Q000209:etiology / Q000628:therapy*; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000628:therapy*; D008297:Male; D026882:Manipulation, Chiropractic / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Chiropractic; Low Back Pain; Treatment Outcome