• Clermont E Dionne, Kate M Dunn, Peter R Croft, Alf L Nachemson, Rachelle Buchbinder, Bruce F Walker, Mary Wyatt, J David Cassidy, Michel Rossignol, Charlotte Leboeuf-Yde, Jan Hartvigsen, Päivi Leino-Arjas, Ute Latza, Shmuel Reis, Maria Teresa Gil Del Real, Francisco M Kovacs, Birgitta Oberg, Christine Cedraschi, Lex M Bouter, Bart W Koes, H Susan J Picavet, Maurits W van Tulder, Kim Burton, Nadine E Foster, Gary J Macfarlane, Elaine Thomas, Martin Underwood, Gordon Waddell, Paul Shekelle, Ernest Volinn, and Michael Von Korff.
• Population Health Research Unit, (URESP) Research Centre of the Laval University Affiliated Hospital, Québec, QC, Canada. clermont.dionne@uresp.ulaval.ca
• Spine. 2008 Jan 1;33(1):95-103.

Study DesignA modified Delphi study conducted with 28 experts in back pain research from 12 countries.ObjectiveTo identify standardized definitions of low back pain that could be consistently used by investigators in prevalence studies to provide comparable data.Summary Of Background DataDifferences in the definition of back pain prevalence in population studies lead to heterogeneity in study findings, and limitations or impossibilities in comparing or summarizing prevalence figures from different studies.MethodsBack pain definitions were identified from 51 articles reporting population-based prevalence studies, and dissected into 77 items documenting 7 elements. These items were submitted to a panel of experts for rating and reduction, in 3 rounds (participation: 76%). Preliminary results were presented and discussed during the Amsterdam Forum VIII for Primary Care Research on Low Back Pain, compared with scientific evidence and confirmed and fine-tuned by the panel in a fourth round and the preparation of the current article.ResultsTwo definitions were agreed on a minimal definition (with 1 question covering site of low back pain, symptoms observed, and time frame of the measure, and a second question on severity of low back pain) and an optimal definition that is made from the minimal definition and add-ons (covering frequency and duration of symptoms, an additional measure of severity, sciatica, and exclusions) that can be adapted to different needs.ConclusionThese definitions provide standards that may improve future comparisons of low back pain prevalence figures by person, place and time characteristics, and offer opportunities for statistical summaries.

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