Back pain: leave well alone

The best course of treatment for acute back pain may be to leave well alone and let it get better on its own, according to French researchers.

French doctors looked at 103 patients who suddenly developed unexplained lower back pain. The researchers excluded patients with a recent history of back problems and those with any obvious cause for the pain, such as cancer, infection, dislocated or fractured vertebrae.

They found that in the overwhelming majority of cases, the condition would right itself without the need for medical intervention. "The recovery rate from acute low back pain was much higher than recorded in other studies," they concluded.

Some 90 per cent of patients in the study recovered within two weeks. Only two didn't recover during the three month period and went on to develop long term back pain. About half of them had bed rest and 40 per cent of those who were employed took no time off work because of the problem.

The study suggests that doctors should not rush to intervene at the onset of sudden back pain, and that it pays to be patient.

"There was a large decrease in pain every day until day four and smaller decreases thereafter," say the researchers BMJ, 26 February 1994.

Doctors in Australia report the case of a patient who suffered persistent headaches for a year following a lumbar puncture a diagnostic test in which a hollow needle is inserted into the spine to draw out cerebrospinal fluid.

Headache is a well established side effect of the technique. However, the pain is usually thought to continue for a matter of days, rather than months.