The patient with chronic low back pain

  • Gunnar B. J. Andersson
  • Thomas W. McNeill


Chronic low back pain is a term used, not to describe the severity of pain, but rather the time period during which a patient has had pain. Although the point in time at which pain becomes “chronic” is arbitrary, we use three months as our limit. This choice is because studies of the natural history of low back pain indicates that 90–95% recover within a three month period and also because patients with low back pain lasting for longer than three months have a poorer prognosis and pose the largest problems in terms of management and cost (Fig. 1). In epidemiologic studies chronic pain has been defined as (a) pain that persists beyond the normal healing time for an acute injury or disease, or (b) pain related to a chronic disease, or (c) pain that emerges and persists or recurs episodically for months or years (Bonica and Chapman, 1986).


Back Pain Chronic Pain Pain Behaviour Chronic Back Pain Chronic Pain Syndrome 
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  1. Addison RG (1984) Chronic pain syndrome. Am J Med 77: 54–58PubMedCrossRefGoogle Scholar
  2. Addison RG (1985) Chronic low back pain. Clin J Pain 1: 50–59CrossRefGoogle Scholar
  3. Bonica JJ, Chapman CR (1986) Biology, pathophysiology, and therapy of chronic pain. In: Berger PA, Keith H, Brodie M (eds) American handbook of psychiatry, vol 8. Basic Books, New York, pp 711–761Google Scholar
  4. Cassel E (1982) The nature of suffering and the goals of medicine. N Engl J Med 306: 11: 639–645PubMedCrossRefGoogle Scholar
  5. Crock HV (1986) Internal disc disruption: a challenge to disc prolapse fifty years on. Spine 11: 650–653PubMedCrossRefGoogle Scholar
  6. Fordyce WE (1976) Behavioural methods in chronic pain and illness. CV Mosby, St. Louis, MOGoogle Scholar
  7. Frymoyer JW, Selby DK (1985) Segmental instability: rationale for treatment. Spine 10: 280–286PubMedCrossRefGoogle Scholar
  8. Loeser JD (1982) Concepts of pain. In: Stanton-Hicks M, Boas R (eds) Chronic low back pain. Raven Press, New York, pp 145–148Google Scholar
  9. Loeser JD, Black RG (1975) Taxonomy of pain. Pain 1: 81–84PubMedCrossRefGoogle Scholar
  10. Mayer TG, Gatchel RJ, Kishino N et al (1986) A prospective short-term study of chronic low back pain patients utilizing novel objective functional measurement. Pain 25: 53–68PubMedCrossRefGoogle Scholar
  11. Mooney V, Robertson J (1976) The facet syndrome. Clin Orthop 115: 149–156PubMedGoogle Scholar
  12. Waddell G (1987) A new clinical model for the treatment of low-back pain. Spine 12: 632–644PubMedCrossRefGoogle Scholar
  13. Waddell G, Main CJ, Morris EW, DiPaola M, Gray ICM (1984) Chronic low back pain, psychological distress and illness behaviour. Spine 9: 209–213PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 1989

Authors and Affiliations

  • Gunnar B. J. Andersson
    • 1
  • Thomas W. McNeill
    • 1
  1. 1.Department of Orthopedic SurgeryRush-Presbyterian-St. Luke’s Medical HospitalChicagoUSA

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