Are localized low back pain and generalized back pain similar entities? Results of a longitudinal community based study

Purpose. To compare subjects with localized low back pain (LBP) and with generalized back pain (BP) with regard to baseline characteristics and long-term outcomes. Methods. A community-based longitudinal study. All inhabitants aged 22-70 of a single town were asked to complete self-administered questionnaires regarding back and neck pain and lifestyle characteristics. Those reporting LBP during the previous month were followed up after one year. Data were stratified by sites of pain with respect to 'localized LBP' and to 'LBP with additional sites of BP'. Among LBP measures were the Roland and Morris Disability scale and Pain symptoms indices. Results. Nearly 30% of the total population (602) experienced LBP during the previous month, of whom more than half (336) reported 'localized LBP' and the rest LBP+neck and or upper back pain (Generalized BP). Both subgroups differed from those free of BP, however, those reported 'Generalized BP' comprised more females, were less educated, smoked more, were less engaged in sporting activities and reported higher level of LBP measures than those reported 'localized LBP'. After one year, both subgroups were similar with regard to lifestyle but remained different with regard to some of the LBP measures. Conclusions. Subjects with 'localized LBP' presented healthier lifestyle than subjects with 'Generalized BP'. The latter experienced higher degree of pain measures. It seems that 'Generalized BP' is not a different entity than 'localized LBP' but rather a more severe one.