Back pain is a double-edged sword.

In most cases, it disappears within about six weeks. But when it doesn’t, low back pain is likely to bother you for the long haul, researchers warn.

“The good news is that most episodes of back pain recover, and this is the case even if you have already had back pain for a couple of months,” said researcher Lorimer Moseley, a professor of physiotherapy and pain management at the University of South Australia in Adelaide. “The bad news is that once you have had back pain for more than a few months, the chance of recovery is much lower.”

More than 570 million people worldwide are affected by low back pain. In the U.S. alone, the bill for treating it added up to $134.5 billion between 1996 and 2016. And costs are increasing.

In a review of 95 studies, an international team compared acute low back pain (less than 6 weeks), subacute back pain (6-12 weeks) and persistent low back pain (more than 12 weeks). 

They report in the Canadian Medical Association Journal that for folks with new back pain, pain and mobility issues eased significantly in the first six weeks, then slowed.

This study closed a gap in a 2012 study from the same team, with new findings showing that many people whose pain lasts more than 12 weeks continue to experience moderate-to-high levels of pain and disability.

“These findings make it clear that back pain can persist even when the initial injury has healed,” Moseley said in a news release. “In these situations, back pain is associated with pain system hypersensitivity, not ongoing back injury.”

That means that if you have back pain on most days for more than a few months, you need a new strategy to get better, he said.

Moseley noted that new treatments based on training both brain and body focus first on understanding that chronic back pain is not a simple problem, and that there is no simple solution. Then, the focus shifts to slowly reducing pain sensitivity and increasing function and participation in meaningful activities.

His team said identifying slowed recovery is important so that care can be stepped up, reducing the likelihood of persistent pain. 

Researchers added that further study is needed to address this common condition and to better understand it in people under 18 and over 60 years of age.

The findings were published Jan. 22.

More information

The Mayo Clinic has more about the causes of back pain.

SOURCE: Canadian Medical Association Journal, news release, Jan. 22, 2024