Detailed Analysis of Back Pain: A Cross‐Sectional Study of Epidemiology and Previous Therapies in a German Population

Diagnosing cLBP is complex due to its heterogeneity, lack of definitive biomarkers, and the subjective nature of pain. This study aims to analyze cLBP patients comprehensively, characterizing demographic and clinical profiles of patients and evaluating the types and effectiveness of previous treatments. From January 2022 to April 2024, we recruited 1262 participants aged between 18 and 72 years from the general population by advertisements and word-of-mouth propaganda. Collected data included a detailed medical history, standardized questionnaires (e.g., Von Korff) and a clinical examination. Our population included 471 (38%) with chronic back pain, 335 (27%) without back pain, and an additional group in between of 327 (26%) with intermittent back pain. The majority of participants experienced multifocal back pain, which was further subdivided based on the predominant pain localization. In patients with localized cLBP (median: 5 years, IQR: 1-10 years), the pain persisted for a shorter time than in the group with predominant back pain other than the lower back (median: 10 years, IQR: 5-15 years). The majority of participants did either use no pain medication at all (cLBP: 32%; iLBP: 37%; no-BP(2): 55%) or on-demand medication (cLBP: 56%; iLBP: 56%; no-BP(2): 39%). Our data show considerable heterogeneity underlying the widespread diagnosis "chronic back pain." Quantitative differentiation is difficult due to the low pain intensity on the day of the examination, and adequate treatment recommendations are challenging. To better understand chronic back pain, there is a strong need for a subclassification. German Clinical Trial Register: DRKS-ID: DRKS00027907.