Sudden onset of back pain

Summary Patients attending a back pain clinic completed a structured interview, with particular reference to whether onset of the first episode of back pain was sudden or insidious. They were classified into four diagnostic groups. A significantly higher proportion of patients who had experienced a sudden onset of pain suffered from sciatic pain with positive root tension signs than was the case with patients whose pain had started more insidiously (50.8% vs. 20.6%; P<0.001). These patients were also more likely to be male, to have been lifting or twisting with a weight, and to have been confined to bed or hospitalised, and have undergone manipulations, than patients with insidious onset of their pain.Research was carried out at the Department of Orthopaedics, Royal Infirmary, Doncaster, UK