Advertisement

European Spine Journal

, Volume 19, Issue 4, pp 533–539 | Cite as

How do we define the condition ‘recurrent low back pain’? A systematic review

  • Tasha R. Stanton
  • Jane Latimer
  • Chris G. Maher
  • Mark J. Hancock
Review Article

Abstract

Recurrent low back pain (recurrent LBP) is a common condition, however, it is unclear if uniform definitions are used in studies investigating the prevalence and management of this condition. The aim of this systematic review was to identify how recurrent LBP is defined in the literature. A literature search was performed on MEDLINE, EMBASE, CINAHL, AMED, and PEDro. Studies were considered eligible if they investigated a cohort of subjects with recurrent LBP or if they were measuring the prevalence of recurrent LBP. Two independent reviewers assessed inclusion of studies and extracted definitions of recurrent LBP. Forty-three studies met the inclusion criteria. The majority of studies (63%) gave an explicit definition of recurrent LBP; however, the definitions varied greatly and only three definitions for recurrent LBP were used by more than one study. The most common feature given as part of the definition was the frequency of previous episodes of low back pain. Only 8% (3/36) of studies used previously recommended definitions for recurrent LBP. Large variation exists in definitions of recurrent LBP used in the literature, making interpretation of prevalence rates and treatment outcomes very difficult. Achieving consensus among experts in this area is required.

Keywords

Recurrent low back pain Non-specific low back pain Definition Review 

Notes

Acknowledgments

We would like to acknowledge Australia’s National Health and Medical Research Council for funding of Professor Chris Maher’s research fellowship.

References

  1. 1.
    Carey TS, Garrett JM, Jackman A, Hadler N, Carey TS, Garrett JM, Jackman A, Hadler N (1999) Recurrence and care seeking after acute back pain: results of a long-term follow-up study. North Carolina Back Pain Project. Med Care 37:157–164CrossRefPubMedGoogle Scholar
  2. 2.
    Von Korff M (1994) Studying the natural history of back pain. Spine 19:2041S–2046SCrossRefGoogle Scholar
  3. 3.
    Stanton TR, Henschke N, Maher CG, Refshauge KM, Latimer J, McAuley JH (2008) After an episode of acute low back pain, recurrence is unpredictable and not as common as previously thought. Spine 33:2923–2928CrossRefPubMedGoogle Scholar
  4. 4.
    Glomsrod B, Lonn JH, Soukop MG, Bo K, Larsen S (2001) “Active back school”, prophylactic management for low back pain: three-year follow-up of a randomized, controlled trial. J Rehabil Med 33:26–30CrossRefPubMedGoogle Scholar
  5. 5.
    Hides JA, Jull GA, Richardson CA (2001) Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine 26:E243–E248CrossRefPubMedGoogle Scholar
  6. 6.
    Lonn JH, Glomsrod B, Soukop MG, Bo K, Larsen S (1999) Active back school: prophylactic management for low back pain. Spine 24:865–871CrossRefPubMedGoogle Scholar
  7. 7.
    Maher C (2000) A systematic review of workplace interventions to prevent low back pain. Aust J Physiother 46:259–269PubMedGoogle Scholar
  8. 8.
    Soukop MG, Glomsrod B, Lonn JH, Bo K, Larsen S (1999) The effect of a mensendieck exercise program as secondary prophylaxis for recurrent low back pain. A randomized, controlled trial with 12-month follow-up. Spine 24:1585–1592CrossRefGoogle Scholar
  9. 9.
    Soukop MG, Lonn JH, Glomsrod B, Bo K, Larsen S (2001) Exercises and education as secondary prevention for recurrent low back pain. Physiother Res Int 6:27–39CrossRefGoogle Scholar
  10. 10.
    Stankovic R, Johnell O (1990) Conservative treatment of acute low-back pain. A prospective randomized trial: McKenzie method of treatment versus patient education in “Mini back school”. Spine 15:120–123CrossRefPubMedGoogle Scholar
  11. 11.
    Stankovic R, Johnell O (1995) Conservative treatment of acute low back pain. A 5-year follow-up of two methods of treatment. Spine 20:469–472CrossRefPubMedGoogle Scholar
  12. 12.
    Brizzi A, Giusti A, Giacchetti P, Stefanelli S, Provinciali L, Ceravolo MG (2004) A randomised controlled trial on the efficacy of hydroelectrophoresis in acute recurrences in chronic low back pain patients. Eur Med Phys 40:303–309Google Scholar
  13. 13.
    Cairns MC, Foster NE, Wright C (2006) Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. Spine 31:E670–E681CrossRefPubMedGoogle Scholar
  14. 14.
    Jones M, Stratton G, Reilly T, Unnithan V (2007) The efficacy of exercise as an intervention to treat recurrent nonspecific low back pain in adolescents. Pediatr Exerc Sci 19:349–359PubMedGoogle Scholar
  15. 15.
    Jones MA, Stratton G, Reilly T, Unnithan VB (2007) Recurrent non-specific low-back pain in adolescents: the role of exercise. Ergonomics 50:1680–1688CrossRefPubMedGoogle Scholar
  16. 16.
    Koumantakis GA, Watson PJ, Oldham JA (2005) Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther 85:209–225PubMedGoogle Scholar
  17. 17.
    Koumantakis GA, Watson PJ, Oldham JA, Koumantakis GA, Watson PJ, Oldham JA (2005) Supplementation of general endurance exercise with stabilisation training versus general exercise only. Physiological and functional outcomes of a randomised controlled trial of patients with recurrent low back pain. Clin Biomech 20:474–482CrossRefGoogle Scholar
  18. 18.
    Little P, Lewith G, Webley F, Evans M, Beattie A, Middleton K, Barnett J, Ballard K, Oxford F, Smith P, Yardley L, Hollinghurst S, Sharp D (2008) Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. BMJ 337:438–441CrossRefGoogle Scholar
  19. 19.
    Roelofs PD, Bierma-Zeinstra SM, van Poppel MN, Jellema P, Willemsen SP, van Tulder MW, van Mechelen W, Koes BW (2007) Lumbar supports to prevent recurrent low back pain among home care workers: a randomized trial (with consumer summary). Ann Intern Med 147:685–692PubMedGoogle Scholar
  20. 20.
    Becker A, Kogell K, Donner-Banzhoff N, Basler HD, Chenot JF, Maitra R, Kochen MM (2003) Low back pain patients in general practice: complaints, therapy expectations and care information. Z Allg Med 79:126–131CrossRefGoogle Scholar
  21. 21.
    Brown FL Jr, Bodison S, Dixon J (1986) Comparison of diflunisal and acetaminophen with codeine in the treatment of initial or recurrent acute low back strain. Clin Ther 9:52–58PubMedGoogle Scholar
  22. 22.
    Bruce B, Lorig K, Laurent D, Ritter P (2005) The impact of a moderated e-mail discussion group on use of complementary and alternative therapies in subjects with recurrent back pain. Patient Educ Couns 58:305–311CrossRefPubMedGoogle Scholar
  23. 23.
    Burton AK, Clarke RD, McClune TD, Tillotson KM (1996) The natural history of low back pain in adolescents. Spine 21:2323–2328CrossRefPubMedGoogle Scholar
  24. 24.
    Burton AK, McClune TD, Clarke RD, Main CJ (2004) Long-term follow-up of patients with low back pain attending for manipulative care: outcomes and predictors. Man Ther 9:30–35CrossRefPubMedGoogle Scholar
  25. 25.
    Cairns MC, Foster NE, Wright CC, Pennington D (2003) Level of distress in a recurrent low back pain population referred for physical therapy. Spine 28:953–959CrossRefPubMedGoogle Scholar
  26. 26.
    Faber E, Burdorf A, Bierma-Zeinstra SMA, Miedema HS, Koes BW (2006) Determinants for improvement in different back pain measures and their influence on the duration of sickness absence. Spine 31:1477–1483CrossRefPubMedGoogle Scholar
  27. 27.
    Feuerstein M, Carter RL, Papciak AS, Feuerstein M, Carter RL, Papciak AS (1987) A prospective analysis of stress and fatigue in recurrent low back pain. Pain 31:333–344CrossRefPubMedGoogle Scholar
  28. 28.
    Gudavalli MR, Cambron JA, McGregor M, Jedlicka J, Keenum M, Ghanayem AJ, Patwardhan AG, Gudavalli MR, Cambron JA, McGregor M, Jedlicka J, Keenum M, Ghanayem AJ, Patwardhan AG (2006) A randomized clinical trial and subgroup analysis to compare flexion-distraction with active exercise for chronic low back pain. Eur Spine J 15:1070–1082CrossRefPubMedGoogle Scholar
  29. 29.
    Harkapaa K, Jarvikoski A, Mellin G, Hurri H, Luoma J, Harkapaa K, Jarvikoski A, Mellin G, Hurri H, Luoma J (1991) Health locus of control beliefs and psychological distress as predictors for treatment outcome in low-back pain patients: results of a 3-month follow-up of a controlled intervention study. Pain 46:35–41CrossRefPubMedGoogle Scholar
  30. 30.
    Hestbaek L, Leboeuf-Yde C, Engberg M, Lauritzen T, Bruun NH, Manniche C (2003) The course of low back pain in a general population. Results from a 5-year prospective study. J Manip Physiol Ther 26:213–219CrossRefGoogle Scholar
  31. 31.
    Kaaria S, Luukkonen R, Riihimaki H, Kirjonen J, Leino-Arjas P, Kaaria S, Luukkonen R, Riihimaki H, Kirjonen J, Leino-Arjas P (2006) Persistence of low back pain reporting among a cohort of employees in a metal corporation: a study with 5-, 10-, and 28-year follow-ups. Pain 120:131–137CrossRefPubMedGoogle Scholar
  32. 32.
    Kaila-Kangas L, Kivimaki M, Harma M, Riihimaki H, Luukkonen R, Kirjonen J, Leino-Arjas P (2006) Sleep disturbances as predictors of hospitalization for back disorders-a 28-year follow-up of industrial employees. Spine 31:51–56CrossRefPubMedGoogle Scholar
  33. 33.
    Leroux I, Dionne CE, Bourbonnais R (2004) Psychosocial job factors and the one-year evolution of back-related functional limitations. Scand J Work Environ Health 30:47–55PubMedGoogle Scholar
  34. 34.
    Li N, Wu B, Wang CW (2005) (Comparison of acupuncture-moxibustion and physiotherapy in treating chronic non-specific low back pain) (Chinese—simplified characters). Zhongguo Linchuang Kangfu (Chin J Clin Rehabil) 9:186–187Google Scholar
  35. 35.
    Linton SJ, Ryberg M (2001) A cognitive-behavioral group intervention as prevention for persistent neck and back pain in a non-patient population: a randomized controlled trial. Pain 90:83–90CrossRefPubMedGoogle Scholar
  36. 36.
    Maul I, Laubli T, Klipstein A, Krueger H (2003) Course of low back pain among nurses: a longitudinal study across eight years. Occup Environ Med 60:497–503CrossRefPubMedGoogle Scholar
  37. 37.
    McGorry RW, Webster BS, Snook SH, Hsiang SM (2000) The relation between pain intensity, disability, and the episodic nature of chronic and recurrent low back pain. Spine 25:834–841CrossRefPubMedGoogle Scholar
  38. 38.
    Mellin G, Hurri H, Mellin G, Hurri H (1990) Referred limb symptoms in chronic low back pain. J Spinal Disord 3:52–58PubMedGoogle Scholar
  39. 39.
    Mikkelsson LO, Nupponen H, Kaprio J, Kautiainen H, Mikkelsson M, Kujala UM (2006) Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study. Br J Sport Med 40:107–113CrossRefGoogle Scholar
  40. 40.
    Moseley GL (2004) Impaired trunk muscle function in sub-acute neck pain: etiologic in the subsequent development of low back pain? Man Ther 9:157–163CrossRefPubMedGoogle Scholar
  41. 41.
    Muller WD, Maier V, Bak P, Smolenski UC (2006) Interlocking between medical rehabilitation and professional reintegration of automobile industry workers with back- and joint pain appraisal by results optimization of the rehabilitation-concept (rehabilitation-plan). Physikalische Medizin Rehabilitationsmedizin Kurortmedizin 16:149–154CrossRefGoogle Scholar
  42. 42.
    Nyiendo J, Haas M, Goodwin P, Nyiendo J, Haas M, Goodwin P (2000) Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medicine physicians: a practice-based feasibility study. J Manip Physiol Ther 23:239–245CrossRefGoogle Scholar
  43. 43.
    Raspe A, Matthis C, Heon-Klin V, Raspe H, Raspe A, Matthis C, Heon-Klin V, Raspe H (2003) Chronic back pain: more than pain in the back. Findings of a regional survey among insurees of a workers pension insurance fund. Rehabilitation (Stuttg) 42:195–203Google Scholar
  44. 44.
    Salminen JJ, Erkintalo MO, Pentti J, Oksanen A, Kormano MJ (1999) Recurrent low back pain and early disc degeneration in the young. Spine 24:1316–1321CrossRefPubMedGoogle Scholar
  45. 45.
    Stanford EA, Chambers CT, Biesanz JC, Chen E (2008) The frequency, trajectories and predictors of adolescent recurrent pain: a population-based approach. Pain 138:11–21CrossRefPubMedGoogle Scholar
  46. 46.
    Stig L, Nilsson O, Leboeuf-Yde C (2001) Recovery pattern of patients treated with chiropractic spinal manipulative therapy for long-lasting or recurrent low back pain. J Manip Physiol Ther 24:288–291CrossRefGoogle Scholar
  47. 47.
    Symmons DP, van Hemert AM, Vandenbroucke JP, Valkenburg HA, Symmons DP, van Hemert AM, Vandenbroucke JP, Valkenburg HA (1991) A longitudinal study of back pain and radiological changes in the lumbar spines of middle aged women. I. Clinical findings. Ann Rheum Dis 50:158–161CrossRefPubMedGoogle Scholar
  48. 48.
    Taimela S, Diederich C, Hubsch M, Heinricy M (2000) The role of physical exercise and inactivity in pain recurrence and absenteeism from work after active outpatient rehabilitation for recurrent or chronic low back pain: a follow-up study. Spine 25:1809–1816CrossRefPubMedGoogle Scholar
  49. 49.
    Triano JJ, Hondras MA, McGregor M (1992) Differences in treatment history with manipulation for acute, subacute, chronic and recurrent spine pain. J Manip Physiol Ther 15:24–30Google Scholar
  50. 50.
    Tsao H, Hodges P (2008) Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain. J Electromyogr Kinesiol 18:559–567CrossRefPubMedGoogle Scholar
  51. 51.
    van den Heuvel SG, Ariens GA, Boshuizen HC, Hoogendoorn WE, Bongers PM, van den Heuvel SG, Ariens GAM, Boshuizen HC, Hoogendoorn WE, Bongers PM (2004) Prognostic factors related to recurrent low-back pain and sickness absence. Scand J Work Environ Health 30:459–467PubMedGoogle Scholar
  52. 52.
    van der Heijden G, Bouter LM, Terpstra-Lindeman E, Essers AHM, Waltje EMH, Koke AJA, Roox GM, Waelen AMW (1991) De effectiviteit van tractie bij lage rugklachten (Dutch). Ned T Fysiotherapie (Dutch J Phys Ther) 101:37–41Google Scholar
  53. 53.
    Wickstrom GJ, Pentti J, Wickstrom GJ, Pentti J (1998) Occupational factors affecting sick leave attributed to low-back pain. Scand J Work Environ Health 24:145–152PubMedGoogle Scholar
  54. 54.
    Yip YB (2002) The association between psychosocial work factors and future low back pain among nurses in Hong Kong: a prospective study. Psychol Health Med 7:223–233CrossRefGoogle Scholar
  55. 55.
    de Vet HCW, Heymans MW, Dunn KMP DP, van der Beek AJ, Macfarlane GJ, Bouter LM, Croft PR (2002) Episodes of low back pain: a proposal for uniform definitions to be used in research. Spine 27:2409–2416CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Tasha R. Stanton
    • 1
  • Jane Latimer
    • 1
  • Chris G. Maher
    • 1
  • Mark J. Hancock
    • 2
  1. 1.The George Institute for International HealthThe University of SydneySydneyAustralia
  2. 2.Back Pain Research Group, Discipline of Physiotherapy, Faculty of Health SciencesThe University of SydneyLidcombeAustralia

Personalised recommendations