Low Back Pain

Are we there yet or do we need to continue to pay attention?

If you are suffering from low back pain, you are definitely not alone.

Did you know that non-specific low back pain, meaning, low back pain which can’t be attributed to a specific pathology, is a major public health problem worldwide?

Did you know that low back pain is the most common physical condition for which people consult their doctors?

Did you know that low back pain is a leading cause of disability and loss of work around the world and that it therefore places a huge financial burden on the economy of most countries?

Are you aware that the financial burden is also related to excess spending on imaging, consultations, and surgery as well as to poor advice and management?

Are you aware that despite all the money spent on various examinations and treatments for low back pain, studies show that suffering patients don’t necessarily feel better nor do they report improvements in their condition or in their functioning?

So it seems pretty clear that we need to continue to pay attention to the global health problem of non-specific low back pain, one which medical researchers have been grappling seriously with for over 2 decades.

Firstly, the researchers tried to identify what causes low back pain and why the tests are not helpful. They concluded that the causes of non-specific low back pain are multifactorial. Some factors are biological: related to our physical make-up and structure and to how we use our bodies. Some are psychological factors: relating to our emotional well-being. Other factors are social: related to our work and social environment and satisfaction levels. The researchers refer to this model for explaining non-specific low back pain, the biopsychosocial model. This conclusion was essential to the advancement of low back pain research and to the path to helping the many sufferers from this debilitating condition. Researchers had a better idea of where to start looking for answers to why all the tests which patients are being sent for and all the treatments they are receiving are not providing sufficient improvement and often not successful at all.

Many studies confirmed that when imaging the lower back, a majority of people have spinal changes. However, the proportion of people with spinal wear and tear did not correlate to the proportion of people with low back pain. The people without pain had the same changes as the people with pain. This groundbreaking finding led to the understanding that spinal wear and tear changes are a normal part of the body’s maturing process and they are not the cause of non-specific low back pain.

Back to more questions…

*So where does this leave us?

*What is the world doing about this worldwide health problem?

*Do doctors know what the best treatment options and management programs are and are they recommending them?

*How effective are the treatment options?

Answers in upcoming posts…

Are They Complying? Physicians’ Knowledge, Attitudes, and Readiness to Change Regarding Low Back Pain Treatment Guideline Adherence.

Epstein-Sher S, et al. Spine (Phila Pa 1976). 2017. PMID: 28207666