title: The course of chronic and recurrent low back pain in the general population.
abstract: Using latent class analysis (LCA), a previous study on patients attending primary care identified four courses of low back pain (LBP) over the subsequent 6 months. To date, no studies have used longitudinal pain recordings to examine the "natural" course of recurrent and chronic LBP in a population-based sample of individuals. This study examines the course of LBP in the general population and elaborates on the stability and criterion-related validity of the clusters derived. A random sample of 400 individuals reporting LBP in a population-based study was asked to complete a comprehensive questionnaire at the start and end of the year's survey, and 52 weekly pain diaries in between. The latter were analyzed using LCA. 305 individuals returned more than 50% of the diaries. Four clusters were identified (severe persistent, moderate persistent, mild persistent, and fluctuating). The clusters differed significantly with regards to pain and disability. Assessment of cluster stability showed that a considerable proportion of patients in the "fluctuating" group changed their classification over time. Three of the four clusters describing the typical course of pain matched the clusters described previously for patients in primary care. Due to the population-based design, this study achieves, for the first time, a close insight into the "natural" course of chronic and recurrent low back pain, including individuals that did not necessarily visit the general practitioner. The findings will help to understand better the nature of this pain in the general population.
authors.affiliation: Institute of Social and Preventive Medicine, University of Berne, Switzerland Spine Center, Schulthess Clinic, Zürich, Switzerland Winterthur Institute of Health Economics WIG, Winterthur, Switzerland Department for Work and Organizational Psychology, University of Bern, Switzerland Institute for Evaluative Research in Orthopaedics, MEM Center, University of Bern, Switzerland.
authors.forename: Oezguer
authors.initials: O
authors.lastname: Tamcan
authors.forename: Anne F
authors.initials: AF
authors.lastname: Mannion
authors.forename: Claudia
authors.initials: C
authors.lastname: Eisenring
authors.forename: Bruno
authors.initials: B
authors.lastname: Horisberger
authors.forename: Achim
authors.initials: A
authors.lastname: Elfering
authors.forename: Urs
authors.initials: U
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002908:Chronic Disease; D004185:Disability Evaluation; D005163:Factor Analysis, Statistical; D005260:Female; D005500:Follow-Up Studies; D058005:General Practitioners; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult