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Proposed Standards for Chronic Low Back Pain Research

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What is Low Back Pain?

Low back pain is a common problem affecting a lot of people nowadays, young and old alike. This problem can bring about ache, tension or stiffness on the back. Back pain is often triggered by bad posture while sitting or standing, bending awkwardly, or lifting incorrectly. Most cases of back pain are not serious and may get better in a few weeks. It can usually be treated by exercise and medications.

There are various causes of back pain, considering that the back is a complex area made up of muscle, joints, bones and nerves. The exact cause of back pain can be difficult to pinpoint. Most causes of back pain are not serious however and are often caused by sprains, minor strains, minor wounds or squeezed nerves. It can be caused by everyday activities either at home or at work or it may develop gradually over time. Its causes may include bending awkwardly or for long periods, lifting, carrying, pushing or pulling incorrectly, slouching in chairs, twisting, over-stretching, driving in a hunched position or driving for long periods without taking a break and overuse of the muscles, usually due to sport or repetitive movements (repetitive strain injury). In some cases, the cause may be unknown.

Not all people have recurring low back pain; only those with risk factors are prone to develop it. Those who are at risk for developing back pain include those who are overweight, those who smoke, those who are pregnant, those who use long term medications that weaken bones such as corticosteroids, and those who experience stress which may cause tension in the back muscles. Those who have depression are also at risk for having back pain since this can lead to weight gain.

Back pain is commonly felt in the lower back but it may also be felt in your spine from the neck to the hips. Some types of back pain and its relations include neck pain, whiplash, shoulder pain, frozen shoulder, ankylosing spondylitis, slipped disc and sciatica. Back pain may bring about symptoms such as soreness, tension and stiffness of the back. The pain may also radiate in the front of the body, the side or the back of the leg. Back pain may also be felt after lifting something heavy or twisting your back awkwardly or it can develop gradually as a result of years of poor posture. Occasionally, it may occur for no apparent reason. It may become worse at night, during activity or after prolonged sitting. It may also be due to a trapped or injured nerve in an area of your back behind your rib cage; in this case, there may also be pain in other areas such as the chest, arms and legs.

Upper or middle back pain may also occur in the base of your neck to the bottom of your rib cage. This area is known as the thoracic spine. It may bring about other signs and symptoms such as weakness in your arms or legs or a numb or tingling sensation in your arms, legs, chest, or abdomen (stomach area). It may also lead to loss of bowel or bladder control.

Proposed Standards for Chronic Low Back Pain Research

According to a Task Force report in the June 15 issue of Spine, the journal published by Lippincott Williams & Wilkins, standardized research methods are needed to make greater progress toward reducing the high burden and costs of chronic low back pain. The report introduces a set of proposed research standards to help in comparing the results of chronic low back pain studies. Key issues included defining the problem of chronic low back pain, assessing its impact on patients’ lives, identifying the minimum dataset that should be collected in chronic low back pain research, and defining the best outcomes to evaluate treatment effectiveness.

The Task Force recommends that chronic low back pain be defined as back pain lasting at least three months, and causing pain on at least half of days over the past six months. The definition does not include ratings of pain severity. The Task Force also recommends focusing on how back pain is affecting patients’ lives. The recommendations suggest a nine-item “Impact Score,” incorporating ratings of pain intensity, interference with normal activities, and functional ability. A minimum set of data should be gathered in any study of chronic low back pain.

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