Project: Recurrent and persistent low back pain

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Low back pain is a highly prevalent and costly condition. It is also a recurrent problem in most cases, and persistent (chronic) in some. However, little is known about the fluctuations, the course, over time. Further, a recurrent condition invites the idea of secondary prevention, in order to minimize the episodes of disability and pain. A persistent condition requires tertiary prevention, to stop deterioration and to minimize the effects of the problem. However, very few preventive strategies have been studied.

In order to investigate a large number of subjects, a new method of gathering frequent data is used: text messages and mobile phones. Weekly measurements provide a detailed picture of course over time, on an individual and a group level. The method is cheap and user-friendly and yields high response rates and good compliance.

In an on-going randomized controlled trial, two preventive strategies are being investigated. The outcome will focus on effect and cost-effectiveness.

Contact persons


Iben Axén

Phone: +46-(0)8-524 832 28
Organizational unit: Intervention and implementation research


  • European Chiropractors' Union
  • Swedish Chiroprators' Association
  • The Danish Chiropractic Association


Analyzing repeated data collected by mobile phones and frequent text messages. An example of low back pain measured weekly for 18 weeks.
Axén I, Bodin L, Kongsted A, Wedderkopp N, Jensen I, Bergström G
BMC Med Res Methodol 2012 Jul;12():105

The use of weekly text messaging over 6 months was a feasible method for monitoring the clinical course of low back pain in patients seeking chiropractic care.
Axén I, Bodin L, Bergström G, Halasz L, Lange F, Lövgren P, et al
J Clin Epidemiol 2012 Apr;65(4):454-61

Clustering patients on the basis of their individual course of low back pain over a six month period.
Axén I, Bodin L, Bergström G, Halasz L, Lange F, Lövgren P, et al
BMC Musculoskelet Disord 2011 May;12():99

The Nordic Maintenance Care Program: when do chiropractors recommend secondary and tertiary preventive care for low back pain?
Axén I, Jensen I, Eklund A, Halasz L, Jørgensen K, Lange F, et al
Chiropr Osteopat 2009 Jan;17():1

Implementation researchIntervention research