Back Pain Phenotypes from the Perspective of the New D-TIMER Concept: From Clinical Heterogeneity to Personalised Therapy

Back pain is a global public health problem characterised by high prevalence, significant economic burden and substantial impact on quality of life. Despite progress in understanding the pathophysiological aspects in the formation of back pain, the development of effective treatments remains a challenge. The traditional approach, which considers back pain as a single disease, does not take into account its inherent clinical heterogeneity. Back pain phenotyping, based on the identification of subgroups of patients with common clinical characteristics, pathophysiological mechanisms and prognosis, represents a promising approach to personalised diagnosis and therapy. This article provides an overview of the current state of research on back pain phenotypes, highlighting different approaches to their identification. The new concept of D-TIMER phenotyping of back pain and the prospects for its use in the development of new diagnostic and therapeutic strategies are presented.