The course of low back pain in a general population. Results from a 5-year prospective study

Objectives: To investigate the course of low back pain (LBP) in a general population over 5 years. Design: Prospective population-based survey by postal questionnaires in 1991, 1992, and 1996. Setting: The municipal of Ebeltoft, Denmark. Subjects: Two thousand people aged 30 to 50 years, representative of the Danish population. Main Outcome Measure: Number of days with low back pain during the past year. Results: One thousand three hundred seventy were recruited of whom 813 (59%) were followed to 5 years. The responders could be divided into 3 groups with regard to LBP: no pain, short-term pain, and long-lasting/recurring pain. More than one third of people who experienced LBP in the previous year did so for >30 days. Forty percent of people with LBP >30 days at baseline remained in that group 1 and 5 years later, and 9% with LBP >30 days in year 0 were pain free in year 5. People with LBP in year 0 were 4 times more likely to have LBP in year 1, and 2 times more likely to be affected in year 5. Conclusions: Low back pain should not be considered transient and therefore neglected, since the condition rarely seems to be self-limiting but merely presents with periodic attacks and temporary remissions. On the other hand, chronicity as defined solely by the duration of symptoms should not be considered chronic. (J Manipulative Physiol Ther 2003;26:213-9)