Functioning description according to the icf model in chronic back pain: disablement appears even more complex with decreasing symptom-specificity.
OBJECTIVE
To determine the significance of degree of symptom-specificity in the disablement condition in chronic back pain.


METHODS
Cross-sectional design.


METHODS
All inhabitants of a restricted geographical area of Norway, who had had 8 weeks of sick-leave due to back pain during a 2-year period, were included in this study. Following examination they were diagnosed as having "specific back pain" (n=34), "non-specific back pain" (n=113) or "widespread pain" (n=49).


METHODS
Functioning of the 3 diagnostic subgroups was described and compared. Functioning assessment was guided by the concepts of the International Classification of Functioning, Disability and Health (ICF): health condition, body function and structure, activity, participation and contextual factors.


RESULTS
Pain components and final participation restriction did not differ among the diagnostic subgroups. However, with increasing symptom-specificity, loss of physical body functions and structures and subsequent activity limitation tended to increase. On the other hand, with decreasing symptom-specificity, mental distress, unfavourable contextual factors and dissatisfaction with various factors of life tend to increase, which may raise the impact of pain on restricting participation in activities.


CONCLUSIONS
Functioning description according to the components of the ICF model indicated that the disablement condition in patients with back pain who had been on sick-leave for 8 weeks may appear more complex with decreasing symptom-specificity.
Hospital for Rehabilitation, Department Stavern, Unit of the Rikshospital University Hospital, Oslo, Norway. marjon.wormgoor@rehabilitering.net
Marjon E A
ME
Wormgoor
Aage
A
Indahl
Maurits W
MW
van Tulder
Han C G
HC
Kemper
D000293:Adolescent; D000328:Adult; D001416:Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D018582:Sick Leave; D011795:Surveys and Questionnaires