Factors related to the onset and persistence of chronic back pain in the community: results from a general population follow-up study.
BACKGROUND
We compared the prevalence of chronic back pain (CBP) at two points 4 years apart and examined socio-demographic, health, and pain-related factors associated with its onset and persistence.


METHODS
A random population sample of 2,184 adults was surveyed in 1996 and resurveyed in 2000. The questionnaire included chronic pain case definition questions (pain for 3 months or longer); the cause (1996) or site (2000) of any chronic pain; the Chronic Pain Grade questionnaire; the Level of Expressed Need (LEN) questionnaire; the SF-36 general health questionnaire; and demographic questions. Those with CBP in 1996 and 2000 had "persistent" CBP; those with CBP in 1996 but not 2000 had "recovered" CBP; those with CBP in 2000 but not 1996 had "new" CBP.


RESULTS
Corrected response rates were 82.3% (1996) and 83.0% (2000). The sample prevalence of CBP was 16% (1996) and 27% (2000). Factors in 1996 independently associated with "persistent" compared with "recovered" CBP were preexisting arthritis, high LEN, poor mental health, and not living alone. Factors independently predicting "new" CBP compared with no previous CBP were previous chronic pain elsewhere and poor physical health. "Persistent" CBP was associated with more severe pain, higher LEN, and poorer general health than "new" CBP.


CONCLUSIONS
CBP is a common and lasting problem, whose persistence and onset are predicted by clinical (especially pain) and help-seeking behavior factors, rather than socio-demographic. Prevention should focus on these factors.
Smith
Blair H
BH
Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen, UK. blairsmith@abdn.ac.uk
Elliott
Alison M
AM
Hannaford
Philip C
PC
Chambers
W Alastair
WA
Smith
W Cairns
WC
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000453:epidemiology*; D015984:Causality; D002908:Chronic Disease; D015897:Comorbidity; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015995:Prevalence; D012008:Recurrence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012606:Scotland / Q000453:epidemiology; D011795:Surveys and Questionnaires