Abstract
Low back pain (LBP) is one of the most common and costly musculoskeletal pain syndromes, affecting up to 80% of people at some point during their lifetime (Katz, 2002; van Tulder et al., 2002; Ehrlich, 2003; Woolf and Pfleger, 2003). It is reported that in spite of the large number of pathological conditions that can give rise to LBP, 85% of these are without a detected pathoanatomical/radiological abnormality. This population is classified as having ‘non-specific’ (NS) LBP (Waddell, 1987, 2004; Dillingham, 1995) which often develops into a chronic fluctuating problem with intermittent flares (Croft et al., 1998; Burton et al., 2004). Optimal treatment for patients with NS-CLBP remains largely enigmatic. Randomized Controlled Trials (RCTs) have failed to find consistent evidence for improved outcomes (Goldby et al., 2000; Cairns et al., 2002; Assendelft et al., 2004; Frost et al., 2004). One explanation offered for the inability to identify effective treatments is the lack of success in defining sub-groups of patients who are most likely to respond to a specific treatment approach (Leboeuf-Yde et al., 1997; Borkan et al., 1998; Bouter et al., 1998). Indeed, it has been proposed that the ‘LBPgroup’ conceals a large heterogeneous group of patients (McKenzie, 1981; Spitzer, 1987; Borkan et al., 1998;
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