The Nordic back pain subpopulation program: course patterns established through weekly follow-ups in patients treated for low back pain

BACKGROUND: Low back pain (LBP) is known to have a fluctuating course. In clinical studies, when deciding on duration of treatment and time for follow-up, it is important to know at what point in time a definite pattern of recovery becomes apparent and at what time a possible recurrence is likely to occur. A detailed description of the pain pattern has been difficult to establish with commonly used methods for follow-up, and we now introduce data collection by means of text messaging on mobile phones. The purpose of this study was to describe the detailed course of LBP during 18 weeks in a population treated in the primary care sector by chiropractors. METHODS: The study population consisted of 78 patients presenting to a chiropractor with LBP, who for at least 12 weeks responded to the questions sent by text messaging concerning 1) the number of LBP-days the preceding week and 2) the intensity of present LBP. RESULTS: A rapid improvement was observed through weeks one to four. After week seven no further improvement happened, and from the 12(th )week there seemed to be a tendency towards worsening. CONCLUSIONS: We suggest that follow-ups in studies concerning primary sector LBP care are conducted in week seven after treatment was initiated and at some later point which cannot be established from this study. In clinical practice we recommend that patients' LBP status is systematically followed for the first four weeks since lack of improvement during that period should cause watchfulness.