Purpose: Lower back disorders are significant and increasing problem in USA and Europe. WE assessed progression and current condition of patients with back pain 5y after initial treatment.

Study design: This was a randomised cohort Level I study. 100 out of the first 1000 of patients seen in our clinic 5y ago were randomisedand re-assessed. Outcome measures included SF36 (PCS and MCS), ODI, VAS, HA and DS scores.

Methods and results: 100 patients were interviewed and assessed for initial complaint, progression of symptoms, time out of work, litigation, other treatments and BPSC treatment satisfaction. 46 males mean age 44.85y(SD=14.43)and 54 females mean age 48.56y (SD=15.39) were included in the study. In 72 patients pain started spontaneously. 15 patients had pain related to industrial injury/RTA. 3 pateints had neck pain and 3 lower back pain related to sports injury. 3 females had postpartum back pain. 6 patients were excluded from the study (4 with no data available, 1 child, 1 death). Mean time out of work for patients with spontaneous back pain was 3.07 weeks (SD 1.83) and for patients with industrial injury/RTA 23.42 weeks (SD 39.92) (p=0.003). Analyzing outcome measures first vs 5y showed: SF36 PCS mean 31.99 vs 50.53 (SD 7.38 vs 6.28) (p<0.001), MCS mean 37.63 vs 53.0 (SD 11.10 vs 6.15) (p<0.001), ODI 40.71 vs 13.94 (SD 20.65 vs 9.41) (p<0.001), HA mean 8.81 vs 2.96 (SD 4.64 vs 1.91) (p<0.001), DS mean 6.51 vs 2.26 (SD 4.32 vs 1.40) (p<0.001) and VAS mean 4.01 vs 0.94 (SD 2.08 vs 1.23) (p<0.001). 93% of patients found BPSC treatment useful.

Conclusion: Significant symptomatic improvement is found in patients five years after initial treatment in BPSC. Time out of work is significantly increased in patients pursuing litigation compared with patients with spontaneous onset of back pain