• Karin E Mantel, Cynthia K Peterson, and B Kim Humphreys.
• Chiropractic Medicine Doctoral Student, Chiropractic Medicine Department, Faculty of Medicine, University of Zürich, Switzerland.
• J Manipulative Physiol Ther. 2016 Mar 1; 39 (3): 141-9.

ObjectiveThe purpose of this study was to compare improvement rates in patients with low back pain (LBP) undergoing chiropractic treatment with 0-2 weeks vs 2-4 and 4-12 weeks of symptoms.MethodsThis was a prospective cohort outcome study with 1-year follow-up including adult acute (symptoms 0-4 weeks) LBP patients. The numerical rating scale for pain (NRS) and Oswestry questionnaire were completed at baseline, 1 week, 1 month, and 3 months after starting treatment. The Patient Global Impression of Change (PGIC) scale was completed at all follow-up time points. At 6 months and 1 year, NRS and PGIC data were collected. The proportion of patients reporting relevant "improvement" (PGIC scale) was compared between patients having 0-2 and 2-4 weeks of symptoms using the χ(2) test at all data collection time points. The unpaired t test compared NRS and Oswestry change scores between these 2 groups.ResultsPatients with 0-2 weeks of symptoms were significantly more likely to "improve" at 1 week, 1 month, and 6 months compared with those with 2-4 weeks of symptoms (P < .015). Patients with 0-2 weeks of symptoms reported significantly higher NRS and Oswestry change scores at all data collection time points. Outcomes for patients with 2-4 weeks of symptoms were similar to patients having 4-12 weeks of symptoms.ConclusionThe time period 0-4 weeks as the definition of "acute" should be challenged. Patients with 2-4 weeks of symptoms had outcomes similar to patients with subacute (4-12 weeks) symptoms and not with patients reporting 0-2 weeks of symptoms.Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

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