Updated March 03, 2015.

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For example, if you think the term "spinal stenosis" is understood and used the same way between patients, doctors, medical scientists, device manufacturers, representatives from the FDA (who approve applications for pain killers and medical devices), physical therapists and holistic practitioners, you may well be mistaken. The NIH says this term is defined differently by researchers in nearly every study.

Related:  Central Canal Stenosis and Neuroformainal Stenosis

The same is true for spine instability, subluxation and radiculopathy, they say.

Other things that are hampered by the lack of consistent terminology across studies on chronic low back pain according to the report include: Pooling data, resolving conflicts when coming to a conclusion about treatment or diagnosis for chronic low back pain, developing consensus among practitioners and experts in related medical disciplines (for example, your pain management specialist, your spine surgeon and your physical therapist), and even getting consensus among practitioners and experts in a single discipline.

CHRONIC LOW BACK PAIN - A NEW DEFINITION PROPOSED

The Research Task Force (RTF) that prepared the Report recommends a definition of chronic low back pain that can be used uniformly throughout all relevant medical studies be adopted. This recommendation is defined by 2 factors:

1.) The length of time back pain has been a problem for you (related to a public health statistical measurement called incidence), and,

2.) What proportion of days in the last 6 months involved you having back pain (related to another statistic called period prevalence). They call this 2nd measurement "pain days." Pain days can accumulate within that 6 month period. For example, the Research Task Force says, if you've had pain on at least half of the days in the last 6 months, you have accumulated at least 3 months worth of pain days.

Related:Incidence

Three months of accumulated low back pain in the past 6 months is the threshold after which pain is defined as chronic, according to the recommendations.

The RTF also recommends classifying chronic low back pain in terms of its impact - in other words, by a combination of the intensity of pain, its interference with your usual activities, and your ability to function physically.

The report gives the RTF's guidelines for what they call a minimal dataset, or the baseline information researchers should be required to collect when doing a study. The Task Force also made recommendations about the way researchers report outcomes (results of treatments) of patients who undergo the treatments studied or being compared in the study.

WHEN WILL BACK TREATMENTS BECOME TRULY EFFECTIVE?

It is likely clear to researchers, practitioners and even patients, that with few exceptions, guidelines for doing medical studies on chronic low back pain, as well as for making recommendations and reporting patient outcomes have historically been a difficult to decipher - and an even more difficult to apply -  hodge podge of terms and methods.

The Research Task Force says it believes its new recommendations can advance the field of chronic low back pain management, as well as help resolve controversies, and better understand the disease. They state that their recommendations are a living document to which continual improvements that are in line with the research recommendations put forth in the Report will be made.

<sub>Sources

Deyo R1, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Carragee E, Carrino J, Chou R, Cook K, DeLitto A, Goertz C, Khalsa P, Loeser J, Mackey S, Panagis J, Rainville J, Tosteson T, Turk D, Von Korff M, Weiner DK. Focus Article Report of the NIH Task Force on Research Standards for Chronic Low Back Pain. Clin J Pain. 2014 Aug;30(8):701-12. doi: 10.1097/AJP.0000000000000120.

Deyo RA, Dworkin SF2, Amtmann D2, Andersson G3, Borenstein D4, Carragee E5, Carrino J6, Chou R7, Cook K8, DeLitto A9, Goertz C10, Khalsa P11, Loeser J2, Mackey S5, Panagis J12, Rainville J13, Tosteson T14, Turk D2, Von Korff M15, Weiner DK9. Report of the NIH Task Force on Research Standards for Chronic Low Back Pain. Spine J. 2014 Jun 17. pii: S1529-9430(14)00463-X. doi: 10.1016/j.spinee.2014.05.002. [Epub ahead of print]

Deyo, R, MD, MPH, et. al. Report of the Task Force on Research Standards for Chronic Low-Back Pain. Submitted to the NIH Pain Consortium Executive Committee. Nov 2013http://painconsortium.nih.gov/NIH_Pain_Programs/Task_Force/cLBP_RTF_FullReport.pdf</sub>