Definitions of Chronic Low Back Pain From a Scoping Review,and Analyses of Narratives and Self-Reported Health of Adults With Low Back Pain |
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| Affiliation: | 2. RAND Corporation, Boston, Massachusetts;3. Department of Medicine, University of California, Los Angeles, California;2. Department of Anesthetic Pharmacology, Jiangsu Province Key Laboratory of Anesthesiology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu Province, China;3. Department of Anesthesiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China;2. Observatoire Français des Médicaments Antalgiques (OFMA) / French monitoring centre for analgesic drugs, Université Clermont Auvergne - CHU Clermont-Ferrand, Clermont-Ferrand, France;3. Institut Analgesia, Faculté de Médecine, Clermont-Ferrand, France;4. CHU Clermont-Ferrand, Secteur Biométrie et Médico-économie, Clermont-Ferrand, France;2. Faculty of Psychology and Neuroscience, Experimental Health Psychology, Maastricht, The Netherlands;3. Institute of Neuroscience, division Cognition and Systems, Faculty of Medicine, UCLouvain, Brussels, Belgium;2. Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland;3. Rovaniemi Health Center, Rovaniemi, Finland;4. SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland;5. Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland;6. Orton Orthopaedics Hospital, Helsinki, Finland;11. Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada;12. Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland;8. Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland |
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| Abstract: | Among those with low back pain (LBP), individuals with chronic LBP (CLBP) face different treatment recommendations and incur the majority of suffering and costs. However, the way CLBP has been defined varies greatly. This study used a scoping review and qualitative and quantitative analyses of data from LBP patients to explore this variation. CLBP in most recent randomized controlled trials (RCTs) was defined by duration of pain, most commonly ≥3 months. However, individuals with LBP most often define CLBP by frequency. CLBP has also been defined using a combination of duration and frequency (16% of RCTs and 20% of individuals), including 6% of recent RCTs that followed the NIH Pain Consortium research task force (RTF) definition. Although not a defining characteristic of CLBP for individuals, almost 15% of recent RCTs required CLBP to have a healthcare provider diagnosis. In our LBP sample moving from ≥3 months to the RTF definition reduced the CLBP group size by 25% and resulted in a group that used more pain management options and reported worse health across all outcome measures. A pain duration definition offers ease of application. However, refinements to this definition (eg, RTF) can identify those who may be better intervention targets.PerspectiveThis article presents the definitions used for CLBP by researchers and individuals, and the impact of these definitions on pain management and health outcomes. This information may help researchers choose better study inclusion criteria and clinicians to better understand their patients’ beliefs about CLBP. |
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