Seeking care for low back pain in the general population: a two-year follow-up study: results from the MUSIC-Norrtälje Study

Spine (Phila Pa 1976). 2002 Oct 1;27(19):2159-65. doi: 10.1097/00007632-200210010-00016.


Study design: A 2-year follow-up study was conducted to investigate new patients who sought care for low back pain from all the caregivers in a specific region with a population of approximately 17,000 men and women ages 20 to 59 years.

Objectives: To describe care-seeking behavior for low back pain in a general population; to characterize pain, disability, and sick leave among the patients; and to study predictors of recovery. An additional aim was to find a simple way of classifying low back pain in epidemiologic studies.

Summary of background data: Low back pain is very common, but its natural history in a general population and predictors of recovery are not fully known.

Methods: All the patients went through a clinical examination, and data on personal, medical, and occupational history were collected. Follow-up assessments were made during a 2-year period.

Results: Whereas 50% of the patients went to physicians and physiotherapists for treatment, 50% went to other caregivers. Some improvements in pain and disability were reported after 3 months, but not many after that. Approximately 70% of the care seekers had not been on sick leave during the follow-up period. Care seeking during the follow-up period was not associated with reduced pain and disability. No predictive factors for recovery were found. A simple pain drawing made by the patient gave information about pain distribution similar to that found by clinical examination.

Conclusions: In a general working population in Sweden ages 20-59 years, approximately 5% sought care because of a new low back pain episode during a 3-year period. Few of the care seekers became pain-free during the follow-up period. This study strengthens the hypothesis that low back pain often becomes chronic even when sick leave is rare.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Age Distribution
  • Caregivers / statistics & numerical data
  • Case-Control Studies
  • Chronic Disease
  • Disability Evaluation
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Low Back Pain / classification
  • Low Back Pain / epidemiology*
  • Low Back Pain / therapy*
  • Male
  • Middle Aged
  • Pain Measurement / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Proportional Hazards Models
  • Risk
  • Sex Distribution
  • Sick Leave / statistics & numerical data
  • Surveys and Questionnaires
  • Sweden / epidemiology