The course of low back pain in a general population. Results from a 5-year prospective study.

Objectives: To investigate the course of low back pain (LBP) in a general population over 5 years.
Design: Prospective population-based survey by postal questionnaires in 1991, 1992, and 1996.
Setting: The municipal of Ebeltoft, Denmark.
Subjects: Two thousand people aged 30 to 50 years, representative of the Danish population. Main outcome measure Number of days with low back pain during the past year.
Results: One thousand three hundred seventy were recruited of whom 813 (59%) were followed to 5 years. The responders could be divided into 3 groups with regard to LBP: no pain, short-term pain, and long-lasting/recurring pain. More than one third of people who experienced LBP in the previous year did so for >30 days. Forty percent of people with LBP >30 days at baseline remained in that group 1 and 5 years later, and 9% with LBP >30 days in year 0 were pain free in year 5. People with LBP in year 0 were 4 times more likely to have LBP in year 1, and 2 times more likely to be affected in year 5.
Conclusions: Low back pain should not be considered transient and therefore neglected, since the condition rarely seems to be self-limiting but merely presents with periodic attacks and temporary remissions. On the other hand, chronicity as defined solely by the duration of symptoms should not be considered chronic.