Abstract

BackgroundIt has been proposed that an episode of low back pain (LBP) be defined as: “a period of pain in the lower back lasting for more than 24 h preceded and followed by a period of at least 1 month without LBP”. Previous studies have tested the definition in the general population and in secondary care populations with distinctly different results. The objectives of this study (in a primary care population) were to investigate the prevalence of 1) the number of consecutive weeks free from bothersome LBP, 2) the prevalence of at least four consecutive weeks free from bothersome LBP at any time during the study period, and 3) the prevalence of at least four consecutive weeks free from bothersome LBP at any time during the study period among subgroups that reported >30 days or ≤30 days of LBP the preceding year.MethodIn this prospective multicentre study subjects with LBP (n = 262) were consecutively recruited from chiropractic primary care clinics in Sweden. The number of days with bothersome LBP was collected through weekly automated text messages. The maximum number of weeks in a row without bothersome LBP and the number of periods of at least four consecutive weeks free from bothersome LBP was counted for each individual and analysed as proportions.ResultsData from 222 recruited subjects were analysed, of which 59 % reported at least one period of four consecutive weeks free from bothersome LBP. The number of consecutive pain free weeks ranged from 82 (at least one) to 31 % (9 or more). In subjects with a total duration of LBP of ≤ 30 days the previous year, 75 % reported a period of 4 consecutive weeks free from bothersome LBP during the study period whereas this was reported by only 48 % of subjects with a total duration of LBP of >30 days the previous year.ConclusionPrevalence of four consecutive pain free weeks is found in the majority of subjects in this population logically reflects duration of LBP within the sample and may be applied on patients in primary care to demarcate a LBP episode.

Highlights

  • It has been proposed that an episode of low back pain (LBP) be defined as: “a period of pain in the lower back lasting for more than 24 h preceded and followed by a period of at least 1 month without Low back pain (LBP)”

  • In subjects with a total duration of LBP of ≤ 30 days the previous year, 75 % reported a period of 4 consecutive weeks free from bothersome LBP during the study period whereas this was reported by only 48 % of subjects with a total duration of LBP of >30 days the previous year

  • In line with de Vet et al’s definition, this is the first study to investigate the applicability of 4 weeks with absence of pain as a demarcation of an episode of LBP [9] in a primary care population

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Summary

Introduction

It has been proposed that an episode of low back pain (LBP) be defined as: “a period of pain in the lower back lasting for more than 24 h preceded and followed by a period of at least 1 month without LBP”. To specify when one episode ends and a new one begins, a period free from pain (in previous research described as a “non-episode” [7, 8]) is required. Recovery is a term that may be used to demarcate such a period with absence of pain following or preceding an episode of LBP. There is no evidence-based definition of recovery [10] to date. Such a definition would aid in the exploration of pain trajectories to subgroup individuals and possibly tailor interventions

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