Q: Is there any chance my low back pain will just go away by itself eventually? I've had it for eight months now. It gets better, then worse, then better, etc.

A: What happens to a condition like low back pain over time without treatment is referred to as the natural course of that particular problem. Most people do seek help for their low back pain, so the true natural course isn't easy to discern.

Thanks to some research being done in Switzerland, we may one-step closer to an answer to this question. The Swiss are famous for carrying out population-based cross-sectional studies. Large numbers of people of all ages and backgrounds participate in group studies of this type. They fill out diaries with information of interest to the researchers. They have regular follow-up assessments.

This particular study was designed to observe the musculoskeletal health of over 16,000 people. Four hundred of those individuals reported having low back pain. The information they provided was used to analyze them as a subgroup.

None of these people with low back pain went to their physician or got any medical treatment for the problem. That was their decision -- it wasn't a requirement of the study. But they agreed to be part of the study and fill out some additional diaries and surveys week-by-week for a full calendar year.

They answered questions about their work, daily life, and participation in sports or recreational activities. They documented their pain level, medication use, and work or social limitations caused by the back pain.

From the results of this study, it looks like the natural course of chronic and recurrent (untreated) low back pain is one of shifting patterns. Most people fall into one of four clusters defined by pain described as: 1) severe persistent, 2) moderate persistent, 3) fluctuating, and 4) mild persistent.

Patients move in and out of these four different phases of low back pain. No matter which group they were in, most of the people in the study still had back pain a year later.

Whether or not these results would be the same with treatment is impossible to tell because the study group couldn't be in both groups (treated vs. untreated) at the same time to compare results.

Reference: Oezguer Tamcan, et al. The Course of Chronic and Recurrent Low Back Pain in the General Population. September 2010. Vol. 150. No. 3. Pp. 451-457.