NIH. US: The Institute of Medicine (2011) has identified chronic pain as a U.S. societal problem of enormous impact. It affects about 100 million adults and has an estimated annual cost of $635 billion, including for direct medical expenditures and loss of work productivity.
Low-back pain (LBP) that limits daily activity has a worldwide lifetime prevalence of about 39 percent and a similar annual prevalence of 38 percent.
Back pain is the second most common neurological ailment in the United States — only headache is more common.
It occurs from adolescence through the elderly. Most people having LBP experience recurrent episodes.
The use of all interventions—including surgery, pharmacologic, and nonpharmacologic approaches—for treatment of chronic LBP (cLBP), sometimes referred to as cLBP syndrome (cLBPS), increased from 1995 to 2010;
despite this, the prevalence of symptoms and expenditures also continued to increase. LBP is a symptom. There is now growing evidence, however, that in its chronic form (cLBP) it can progress, like other chronic pain conditions,7 beyond a symptomatic state to a complex condition unto itself. This can include persistent anatomical and functional changes in the central nervous system, in addition to changes in the back (e.g., degenerative spinal changes and atrophy and/or asymmetry of paraspinal muscles). Although some patients with cLBP have clear pathoanatomic etiologies, for most there is no clear association between their pain and an identifiable pathology of the spine and its associated soft tissues (i.e., intervertebral discs, ligaments, joint capsules, and muscles). Furthermore, it is often not possible to identify mechanisms to account for the appreciable negative impact cLBP has on the lives of many sufferers.
Such pain is often termed nonspecific, idiopathic, mechanical, or due to instability, and it may in fact be due to different and multiple biologic and behavioral etiologies in different individuals.
Question set about low back pain