The Nordic back pain subpopulation program--individual patterns of low back pain established by means of text messaging: a longitudinal pilot study

Chiropr Osteopat. 2009 Nov 17:17:11. doi: 10.1186/1746-1340-17-11.


Background: Non-specific low back pain (LBP) is known to be a fluctuating condition and there is a growing realisation that it consists of different subgroups of patients. The detailed course of pain is not known since traditional methods of data collection do not allow very frequent follow-ups. This is a limitation in relation to identification of subgroups with different course patterns. The objective of this pilot study was to see if it is possible to identify characteristic course-patterns of non-specific LBP in patients treated in a primary care setting.

Methods: Patients seeing a chiropractor for a new LBP episode were included after the first consultation and followed for 18 weeks by means of automatic short message service (SMS) received and returned on their mobile phones. Every week they were asked how many days they had experienced LBP in the preceding week. The course of pain was studied for each individual and described as an early course (1st - 4th week) and a late course (5th - 18th week), which was fitted into one of 13 predefined course patterns.

Results: A total of 110 patients were included from 5 chiropractic clinics, and the study sample consisted of the 78 patients who participated at least until week 12. Nine of the predefined patterns were identified within this population. The majority of patients improved within the first four weeks (63%), and such early improvement was associated with a generally favourable course.

Conclusion: Patients with nonspecific LBP were shown to have a number of different course-patterns. The next step is to explore whether the identified patterns relate to different LBP diagnoses.