Low back pain is a prevalent cause of disability worldwide, affecting over 570 million individuals. In the United States, the expenditure on low back pain-related healthcare reached $134.5 billion from 1996 to 2016, and these costs are on the rise.

Fortunately, the majority of instances of back pain demonstrate recovery, even in cases where the condition has persisted for several months, according to Professor Lorimer Moseley from the University of South Australia. However, the downside is that prolonged back pain, lasting beyond a few months, significantly diminishes the chances of recovery. This highlights the variability in how individuals respond to back pain, an aspect not entirely understood.

A comprehensive systematic review and meta-analysis, undertaken by an international research team, encompassed 95 studies aiming to elucidate the clinical progression of acute (less than 6 weeks), subacute (6 to less than 12 weeks), and persistent (12 to less than 52 weeks) low back pain.

The study revealed that for those experiencing new back pain, there was a notable reduction in pain and mobility issues within the initial 6 weeks, after which the recovery pace decelerated. Unlike a 2012 paper from the same research team, these new findings demonstrated that individuals with persistent low back pain (exceeding 12 weeks) continued to endure moderate-to-high levels of pain and disability.

The study underscores that even after the initial injury has healed, back pain can persist, linked to heightened sensitivity in the pain system rather than ongoing injury. Professor Moseley emphasizes the need for a fresh approach to addressing chronic back pain, suggesting new treatments that integrate both brain and body training, focusing on understanding the complexity of chronic back pain and gradually reducing pain system sensitivity while enhancing functionality and engagement in meaningful activities.

The authors stress the importance of identifying delayed recovery in individuals with subacute low back pain to escalate care and diminish the likelihood of persistent pain. Further research is deemed essential to explore treatments for this prevalent and debilitating condition, particularly in populations younger than 18 and older than 60 years.

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