• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. May 1999; 49(442): 358–362.
PMCID: PMC1313420

Is chronic non-specific low back pain chronic? Definitions of a problem and problems of a definition.


BACKGROUND: Chronic low back pain (LBP) accounts for the majority of the disability and costs for LBP. However, the definition of chronicity is unclear. AIM: To elicit practitioners' definitions of chronic LBP patients, both in general and in the patients they were treating; to assess the most common characteristics of these practitioners' chronic LBP patients; and to assess the stability of chronicity in a sample of the general population. METHOD: Semi-structured interviews were conducted with 33 practitioners working in private practice, 71 LBP patients and their therapists, and 252 employees of a chain store who were assessed yearly in a prospective study. RESULTS: The therapists' definitions of chronic LBP patients generally included psychosocial aspects. Only physical symptoms and signs were stressed in the patients they were treating. These patients displayed common characteristics with reference to pain, functional problems, and contact with health care services. Duration of symptoms was not sufficient to define chronicity. In the employee population, chronicity defined according to pain duration was unstable. However, the same was true when chronicity was measured according to the criteria defined in the patient population. CONCLUSION: There is a discrepancy between theory and practice regarding the definition of chronic LBP. This discrepancy concerns not only the literature but also clinical practice itself. The term 'chronic' LBP as currently used is therefore equivocal.

Full Text

The Full Text of this article is available as a PDF (49K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Nachemson AL. Advances in low-back pain. Clin Orthop Relat Res. 1985 Nov;(200):266–278. [PubMed]
  • Deyo RA, Phillips WR. Low back pain. A primary care challenge. Spine (Phila Pa 1976) 1996 Dec 15;21(24):2826–2832. [PubMed]
  • Frank A. Low back pain. BMJ. 1993 Apr 3;306(6882):901–909. [PMC free article] [PubMed]
  • Deyo RA. Practice variations, treatment fads, rising disability. Do we need a new clinical research paradigm? Spine (Phila Pa 1976) 1993 Nov;18(15):2153–2162. [PubMed]
  • Von Korff M, Deyo RA, Cherkin D, Barlow W. Back pain in primary care. Outcomes at 1 year. Spine (Phila Pa 1976) 1993 Jun 1;18(7):855–862. [PubMed]
  • Von Korff M, Saunders K. The course of back pain in primary care. Spine (Phila Pa 1976) 1996 Dec 15;21(24):2833–2839. [PubMed]
  • Angermeyer MC, Matschinger H. Lay beliefs about schizophrenic disorder: the results of a population survey in Germany. Acta Psychiatr Scand Suppl. 1994;382:39–45. [PubMed]
  • Papageorgiou AC, Croft PR, Thomas E, Ferry S, Jayson MI, Silman AJ. Influence of previous pain experience on the episode incidence of low back pain: results from the South Manchester Back Pain Study. Pain. 1996 Aug;66(2-3):181–185. [PubMed]
  • Croft PR, Papageorgiou AC, Ferry S, Thomas E, Jayson MI, Silman AJ. Psychologic distress and low back pain. Evidence from a prospective study in the general population. Spine (Phila Pa 1976) 1995 Dec 15;20(24):2731–2737. [PubMed]
  • Cedraschi C, Reust P, Roux E, Vischer TL. The role of prior knowledge on back-pain education. J Spinal Disord. 1992 Sep;5(3):267–276. [PubMed]
  • Gore DR, Sepic SB, Gardner GM, Murray MP. Neck pain: a long-term follow-up of 205 patients. Spine (Phila Pa 1976) 1987 Jan-Feb;12(1):1–5. [PubMed]
  • Frymoyer JW. Back pain and sciatica. N Engl J Med. 1988 Feb 4;318(5):291–300. [PubMed]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...