Conclusions For most clinical tests in LBP there is not consistent evidence for an association with outcome .
Central ization and non-organic signs are exceptions from that .
Background There is a strong tradition of performing a clinical examination of low back pain ( LBP ) patients and this is generally recommended in guidelines .
However , establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors .
The aim of this review of the literature was to systematic ally assess the association between low-tech clinical tests commonly used in adult patients with acute , recurrent or chronic LBP and short- and long-term outcome .
The Prognosis of Low Back Pain in General Practice
Study Design . A prospect i ve cohort study on low back pain in consecutive patients in general practice , in which potential prognostic indicators at baseline and at the 1-year follow-up examination were assessed by means of four weekly question naires . Objectives . To identify prognostic indicators of the duration of low back pain in general practice and the occurrence of a relapse . Background . Little is known about the prognosis of low back pain in general practice . Different design s and different results of preceding studies make drawing conclusions about the prognostic indicators , if any , of the course of low back pain in general practice difficult . Methods . For a period of 2 years , 15 general practitioners from Amsterdam and surrounding areas studied consecutive patients with chronic low back pain and those with a recent onset of low back pain . A large number of potential prognostic indicators were assessed at the initial visit . After the initial visit , each patient was monitored for a period of 12 months . The follow-up assessment was conducted with four weekly postal question naires . The associations among the potential prognostic indicators , the duration of the index episode , and the occurrence of a relapse were analyzed using multivariate Cox regression and logistic regression analysis , respectively . Results . Of the 605 patients identified , 443 were included in the follow-up period of assessment ; the question naires were completed by 269 patients . In general , patients with less severe low back pain participated less often or did not complete the follow-up study . Thirty-five percent of the population still experienced low back pain after 12 weeks , and 10 % still experienced it after 1 year . Approximately three of every four patients whose index episode ended before the end of the follow-up period had one or more relapses within a year . The analysis result ed in a model with four variables predicting the duration of the low back pain , including " the duration of the low back pain preceding the initial visit , " " receiving physical therapy , " " pain intensity , " and " history of back surgery . " Daily functioning appeared to be the only variable that was significantly associated with the occurrence of a relapse . Conclusions . Only a few variables appear to be related to the clinical course of low back pain seen in general practice . In particular , the duration preceding the initial visit and , unexpectedly , receiving physical therapy were both associated with a longer duration of low back pain
Conclusions For most clinical tests in LBP there is not consistent evidence for an association with outcome .
Central ization and non-organic signs are exceptions from that .
Background There is a strong tradition of performing a clinical examination of low back pain ( LBP ) patients and this is generally recommended in guidelines .
However , establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors .
The aim of this review of the literature was to systematic ally assess the association between low-tech clinical tests commonly used in adult patients with acute , recurrent or chronic LBP and short- and long-term outcome .