From the Guidelines
Subacute low back pain is defined as a time period lasting from 4 to 12 weeks, according to the Institute for Clinical Systems Improvement definitions 1. This definition is crucial in guiding treatment algorithms for back pain, as the duration of symptoms helps determine the appropriate course of action.
Key Points
- The subacute phase is an intermediate stage between acute and chronic conditions, lasting from 4 to 12 weeks 1.
- This phase is critical for intervention, as addressing underlying causes during this period can prevent progression to a chronic state.
- Subacute care settings provide services designed to help patients transition from acute hospital care to either returning home or moving to long-term care facilities.
Clinical Importance
The subacute phase is important clinically because it often represents a critical window for intervention that can prevent progression to a chronic state. For example, in subacute pain management, addressing the underlying causes during this period may prevent the development of chronic pain syndromes. Similarly, in subacute care settings, patients receive services designed to help them transition from acute hospital care to either returning home or moving to long-term care facilities, typically over a period of several weeks.
Evidence-Based Recommendation
The most recent and highest quality study, published in 2021, defines subacute low back pain as a time period lasting from 4 to 12 weeks 1. This definition is based on the Institute for Clinical Systems Improvement definitions and is consistent with current clinical guidelines. Therefore, it is recommended to use this definition in clinical practice to guide treatment algorithms for back pain.
From the Research
Definition of Subacute Period
The subacute period refers to a specific time frame after a medical event, such as a stroke.
- The subacute period after a stroke is defined as the time when the decision to not employ thrombolytics is made up until two weeks after the stroke occurred 2.
- This period is critical for the management and treatment of stroke patients, including the initiation of antiplatelet therapy and other preventive measures.
Time Frame of Subacute Period
The time frame of the subacute period can vary depending on the specific context and medical condition.
- In the context of ischemic stroke, the subacute period typically lasts up to two weeks after the stroke occurred 2.
- For high-risk transient ischemic attack or minor ischemic stroke, dual antiplatelet therapy with aspirin and clopidogrel is recommended for 10-21 days 3.
- The exact duration of the subacute period may depend on various factors, including the severity of the stroke and the individual patient's condition.
Clinical Implications
The subacute period has significant clinical implications for the management and treatment of stroke patients.
- During this period, patients are at risk of developing complications such as venous thromboembolism, pressure sores, infection, and delirium 2.
- Antiplatelet therapy, such as aspirin, is often initiated during the subacute period to reduce the risk of recurrent stroke 2, 3, 4.
- The subacute period is also critical for the initiation of rehabilitative therapy, which can improve outcomes and reduce the risk of long-term disability 2.