Unravelling the mysteries of back pain

Researchers at Keele University in Staffordshire, UK, have begun to disentangle the problem of chronic back pain using new statistical analyses.

They found that simply describing people as having "chronic back pain" might not be very useful.

The team from the Primary Care Sciences Research Centre at Keele carried out an in depth study of how peoples' back pain changed over time and found four different pathways.

Dr Kate Dunn said: "We have found that people experience different 'pain pathways', which might need different types of treatment."

"The use of an 'umbrella term' of chronic does not seem appropriate and our classification into four pathways of persistent mild, recovering, fluctuating and severe chronic does provides a more detailed alternative. Classification of primary care patients into these groups may help the management of non-specific low back pain and contribute to future trials of treatment."

Understanding the course of low back pain is important for clinicians and researchers because it provides information on the need for, and potential benefits of, treatment. It also helps patients learn what to expect in terms of symptoms, the impact of the problem on their life and the treatments they may receive.

The aim of the study was to identify and describe groups of primary care low back pain patients defined by their patterns of change in, or stability of, pain over time.

The researchers found that although most people report that their back pain improves after visiting their GP, not everyone recovers completely. Some people constantly have severe pain, many continue to have mild but lasting symptoms and a few find that their back pain fluctuates.

The analysis was based on data for 342 primary care low back pain sufferers, aged 30 to 59, in Staffordshire, who took part in the study.

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