The problem that is Low Back Pain
The worldwide burden of low back pain is increasing and despite the best efforts of the various health professions.
Low back pain is now the number one cause of disability.
It is now widely recognised that the problem has been created in part by the medical system with an emphasis on imaging investigations, medication, injections and surgery.
This very informative research paper recently published in the Lancet medical journal presents the epidemiology, causes, natural history and factors associated with persistent low back pain.
1. It’s extremely common among all ages with a 54% increase in disability since 1990, projected to worsen in the future
2. Although most episodes are short-lasting, but it is increasingly understood as a long-lasting condition with a variable course.
3. Low back pain is a complex condition with multiple contributors to both the pain and associated disability, including psychological factors, social factors, biophysical factors, comorbidities, and pain-processing mechanisms.
4. Lifestyle factors (smoking, obesity, and low levels of physical activity) are associated with low back pain.
Given the complexity of low back pain, there is often no quick fix, no silver bullet so to speak. Surgical procedures certainly have a role to play in a small percentage of low back pain sufferers when specific pathology is present such as a fracture, tumour, or severe disc bulge which may be pressing on a nerve.
For most with low back pain, there are many causes all contributing at the same time. It is rarely just a disc or just a joint or something being ‘out of place’. As such a multi-modal approach is required.
Next week I’ll discuss how best to prevent and treat low back pain according to the latest evidence from various countries.