title: Back pain recurrence: an evaluation of existing indicators and direction for future research.
abstract: METHODS
  Literature review.
  
  
  OBJECTIVE
  To present a framework for future analyses of back pain recurrence and explore the applicability and relevance of existing recurrence indicators.
  
  
  BACKGROUND
  Empirical studies of back pain have included a variety of indicators of recurrence, resulting in a range of findings about recurrence rates and associated factors. Little is known about the relationships between existing indicators.
  
  
  METHODS
  Literature overview, expert panel, and workshop discussion at the IX International Forum on Primary Care Research on Low Back Pain.
  
  
  RESULTS
  Using the International Classification of Functioning, Disability, and Health (ICF), disabling back pain was conceptualized as a health condition, i.e., back pain disorder (BPD), and BPD recurrence was conceptualized as involving a return of atypical back pain and/or back-pain-related difficulty performing tasks and actions related to the initial episode. Using the ICF, 2 types of recurrence indicators were identified: those directly describing components of BPD and those indirectly doing so (e.g., recurrence of health care utilization).
  
  
  CONCLUSIONS
  In light of the difficulty in measuring BPD recurrence, transparent definitions and a clear understanding of the implications of using particular indicators is required. Future research should focus: on examining the capture BPD recurrence by various research instruments, improving understanding of the relationship between indicators, and gaining insight into how individuals experiencing BPD view recurrence.
authors.affiliation: United BioSource Corporation, London, United Kingdom. radek.wasiak@unitedbiosource.com
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Wasiak
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Young
authors.forename: Kate M
authors.initials: KM
authors.lastname: Dunn
authors.forename: Pierre
authors.initials: P
authors.lastname: Côté
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Gross
authors.forename: Martijn W
authors.initials: MW
authors.lastname: Heymans
authors.forename: Michael
authors.initials: M
authors.lastname: von Korff
mesh_terms: D001416:Back Pain / Q000145:classification* / Q000175:diagnosis*; D004185:Disability Evaluation; D005544:Forecasting; D006801:Humans; D012008:Recurrence; D012106:Research / Q000639:trends; D012107:Research Design; D012196:Review Literature as Topic; D012720:Severity of Illness Index