Seeking care for low back pain in the general population: a two-year follow-up study: results from the MUSIC-Norrtälje Study.
METHODS
A 2-year follow-up study was conducted to investigate new patients who sought care for low back pain from all the caregivers in a specific region with a population of approximately 17,000 men and women ages 20 to 59 years.


OBJECTIVE
To describe care-seeking behavior for low back pain in a general population; to characterize pain, disability, and sick leave among the patients; and to study predictors of recovery. An additional aim was to find a simple way of classifying low back pain in epidemiologic studies.


BACKGROUND
Low back pain is very common, but its natural history in a general population and predictors of recovery are not fully known.


METHODS
All the patients went through a clinical examination, and data on personal, medical, and occupational history were collected. Follow-up assessments were made during a 2-year period.


RESULTS
Whereas 50% of the patients went to physicians and physiotherapists for treatment, 50% went to other caregivers. Some improvements in pain and disability were reported after 3 months, but not many after that. Approximately 70% of the care seekers had not been on sick leave during the follow-up period. Care seeking during the follow-up period was not associated with reduced pain and disability. No predictive factors for recovery were found. A simple pain drawing made by the patient gave information about pain distribution similar to that found by clinical examination.


CONCLUSIONS
In a general working population in Sweden ages 20-59 years, approximately 5% sought care because of a new low back pain episode during a 3-year period. Few of the care seekers became pain-free during the follow-up period. This study strengthens the hypothesis that low back pain often becomes chronic even when sick leave is rare.
Vingård
Eva
E
National Institute for Working Life, Solna, Sweden. eva.vingard@cns.ki.se
Mortimer
Monica
M
Wiktorin
Christina
C
Pernold R P T
Gunilla
G
Fredriksson
Kerstin
K
Németh
Gunnar
G
Alfredsson
Lars
L
D000203:Activities of Daily Living; D000328:Adult; D017677:Age Distribution; D017028:Caregivers / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002908:Chronic Disease; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000145:classification / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012306:Risk; D017678:Sex Distribution; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology