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Low Back Pain Facts
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Low Back Pain Facts
1. Low back pain is common, affecting 18% of the adult population in the United States during any given month. This equates to over 56 million adults experiencing low back pain each month (1).
2. The majority of low back pain improves on its own within six weeks.
3. Low back pain is often intermittent and recurrent, meaning an individual has long periods without low back pain followed by periods with low back pain that resolve on their own most of the time.
4. 85% of patients with low back pain cannot be given a precise pathoanatomical diagnosis (2). This simply means 85% of people with low back pain cannot be given an exact reason their back hurts. A specific tissue cannot be singled out as the pain generator.
5. At this point in time modern medicine is advanced and complex. We have the ability to see the spine with x-rays, MRI’s, and CT scans. There are numerous surgical options, pharmaceuticals, and injections used to treat low back pain, and this is how low back pain is often addressed because patients feel these are the best options and treatments. The research over the past two decades shows the opposite. Below is the exact summary from the American College of Physicians of what patients and doctors should do about low back pain. This was written in 2011.
Doctors should use a patient’s history and physical examination to determine whether the low back pain is musculoskeletal or due to a serious condition.
Doctors should not order x-ray, CT, or MRI unless they suspect a serious cause of low back pain.
Patients with musculoskeletal low back pain need information so that they understand why they do not need tests even though their backs hurt.
Doctors and patients should discuss the expected course of low back pain; the importance of remaining active; medications for pain and inflammation; and self-care options, such as heating pads, exercise, and other nondrug treatments (3).
This being said patients with low back pain will invariably question if their low back pain is due to a serious underlying condition. Due to this question they may feel x-rays and/or MRI’s are required. Some more statistics: 1% of low back pain cases are due to non-mechanical spinal conditions (neoplasia, inflammatory arthritis, and infection). 2% are classified as non-spinal/visceral disease (pelvic and renal organs, aortic aneurysm, GI system, shingles) (1). This leaves 97%. 97% of all low back pain is mechanical in nature meaning it’s due to dysfunction of muscles, joints, nerves, etc. So if you have low back pain, the chances of it being something serious are very small and any decent health care practitioner will recognize red flags that may warrant further work up.
1. Kinkade S. (2007). Evaluation and Treatment of Acute Low Back Pain. Am Fam Physician. Apr 15;75(8):1181-1188.
2. Deyo RA and Weinstein JN. (2001). Low back pain. N Engl J Med 344:363-370.
3. Radiology Tests for Patients With Low Back Pain: High-Value Health Care Advice From the American College of Physicians. Annals of Internal Medicine. 2011 Feb;154(3):I-36.