Ten year course of low back pain in an adult population-based cohort--the Doetinchem cohort study

Background: The long-term course of long-standing low back pain is largely unknown since long-term data are scarce.

Objective: We examined the course of self-reported low back pain in the prospective population-based Doetinchem cohort over a period of 10years.

Methods: Between 1993 and 2007, around 5700 randomly selected men and women in four age groups of originally 20-29, 30-39, 40-49, 50-59years were measured three times. Logistic regression analysis was used to study the association of sociodemographic (gender, age, education, work status) and lifestyle characteristics (BMI, smoking, physical activity) with persistent and new episodes of long-standing low back pain.

Results: The prevalence of long-standing low back pain is quite stable over a 10year period, approximately 20% on population level. On individual level, around 30% of the population was completely free of low back pain during the entire period, 6% can be characterized as persistent back pain sufferers. Individuals with persistent and a varying pattern have a more unhealthy lifestyle (BMI and smoking) than those without low back pain. Age, smoking, obesity and not having a paid job are associated with 10-year persistent back pain in the general population, whereas age and not having a paid job are associated in those with long-lasting back pain at baseline. New episodes of long-standing back pain are relatively frequent among women and smokers.

Conclusions: Low back pain in the population is characterized as very dynamic which challenges epidemiological studies highly. Long-term information on the course of back pain is needed to define severe subgroups.