Low back pain (LBP) affects at least 80% of us some time in our lives, perhaps 20-30% of us at any given time. It is the fifth most common reason for all physician visits in the U.S. It is usually recurrent, and subsequent episodes tend to increase in severity. It is common in individuals who lead sedentary lives and in those who engage in manual labor. It can occur at any age but is most prevalent during the third to sixth decades of life.
Tremendous costs are associated with LBP including lost productivity and income from work, the expense of medical, rehabilitation and surgical interventions, and the costs of disabling pain and limited daily function. Total incremental direct health care costs attributable to low back pain in the U.S. were estimated at $26.3 billion in 1998 (4). In addition, indirect costs related to days lost from work are substantial (Chou R, et al.) Back pain is second only to upper respiratory conditions as the stated cause of work loss. The costs for treatment and compensation for LBP in industry may be greater than the total amount spent on all other industrial injuries combined. However, most of the costs, perhaps 80%, are incurred by about 20% of the LBP patients who then become disabled.
LBP has been and is currently treated with almost every modality known to man including prolonged bed rest, narcotics, surgery, heat, cold, exercise, immobilization, flexion, extension, traction, massage, manipulation, mobilization, muscle relaxants, etc., etc. LBP is a self-limiting disease which means that in time most patients recover regardless of treatment; 80-90% of patients with acute LBP recover in about six weeks, and nearly 60% of LBP patients return to work within one week. Since LBP is usually self-limiting and recurrent about 90% of the time, we should teach patients how to avoid LBP and how to self-treat.