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 di sability and costs for LBP. However, the definition of chronicity is unclea r. 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 work ing in private practice, 71 LBP patients and their therapists, and 252 empl oyees of a chain store who were assessed yearly in a prospective study. Results. The therapists' definitions of chronic LBP patients generally incl uded psychosocial aspects. Only physical symptoms and signs were stressed i n the patients they were treating. These patients displayed common characte ristics with reference to pain, functional problems, and contact with healt h care services. Duration of symptoms was not sufficient to define chronici ty In the employee population, chronicity defined according to pain duratio n was unstable. However, the same was true when chronicity was measured acc ording to the criteria defined in the patient population. Conclusion. There is a discrepancy between theory and practice regarding th e definition of chronic LBP. This discrepancy concerns not only the literat ure but also clinical practice itself The term 'chronic' LBP as currently u sed is therefore equivocal.