DOI: 10.1080/16501970510044052

Objective: To determine the significance of degree of symptom-specificity in the disablement condition in chronic back pain. Design: Cross-sectional design. Subjects: All inhabitants of a restricted geographical area of Norway, who had had 8 weeks of sick-leave due to back pain during a 2-year period, were included in this study. Following examination they were diagnosed as having “specific back pain” (n =34), “non-specific back pain” (n =113) or “widespread pain” (n =49). Methods: Functioning of the 3 diagnostic subgroups was described and compared. Functioning assessment was guided by the concepts of the International Classification of Functioning, Disability and Health (ICF): health condition, body function and structure, activity, participation and contextual factors. Results: Pain components and final participation restriction did not differ among the diagnostic subgroups. However, with increasing symptom-specificity, loss of physical body functions and structures and subsequent activity limitation tended to increase. On the other hand, with decreasing symptom-specificity, mental distress, unfavourable contextual factors and dissatisfaction with various factors of life tend to increase, which may raise the impact of pain on restricting participation in activities. Conclusion: Functioning description according to the components of the ICF model indicated that the disablement condition in patients with back pain who had been on sick-leave for 8 weeks may appear more complex with decreasing symptom-specificity.