Description

• Low back pain (LBP) is extremely common and is characterized by duration or associated symptoms.
• Duration
  • Acute (<6 weeks)
  • Subacute (>6 weeks but <3 months)
  • Chronic (>3 months)
• Associated symptoms
  • Localized/nonspecific “mechanical” LBP
  • Back pain with lower extremity symptoms
  • Systemic and visceral symptoms
• A specific cause is not found for most patients with LBP. Most cases resolve in 4 to 6 weeks.
• Rule out “red” flag symptoms indicating the need for immediate intervention.
• System(s) affected: musculoskeletal, neurologic
• Synonym(s): lumbago, lumbar sprain/strain, low back syndrome

Epidemiology

Incidence
1-year incidence for first episode: 6.3–15.3%; 1-year incidence for any episode: 1.5–3.6%

Prevalence

• Lifetime prevalence: 84%
• Predominant sex: male = female
• Highest incidence in ages 20 to 29 years; prevalence increases with age until 65 years and then declines.

Etiology and Pathophysiology

• LBP can be commonly due to muscle spasm/tension.
• ~39% of chronic LBP due to disk degeneration, ~30% from facet joint syndrome. Other possibilities include sacroiliac injuries/degeneration and spinal stenosis.

Risk Factors

• Age
• Activity (lifting, sudden twisting, bending)
• Obesity
• Sedentary lifestyle
• Physically strenuous work
• Psychosocial factors—anxiety, depression, stress
• Genetic factors
• Heavy operating equipment
• Poor flexibility
• Smoking

General Prevention

• Maintain normal weight.
• Adequate physical fitness and activity
• Stress reduction
• Proper lifting technique and good posture
• Smoking cessation