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Low Back Pain: Why Is It So Common?

Low back pain affects a large part of the population. This article investigates why low back pain is so common, and what can be done about it.

This question has plagued all of us, including researchers for a long time!  Could it be because we’re all inherently lazy and don’t exercise enough? Or maybe it’s because we have a job that’s too demanding on our back?  To properly address this question, here are some interesting facts:

1.    The prevalence of low back pain (LBP) is common, as 70-85% of ALL PEOPLE have back pain that requires treatment of some sort at some time in life.

2.    On a yearly basis, the annual prevalence of back pain averages 30% and once you have back pain, the likelihood of recurrence is high.

3.    Back pain is the most common cause of activity limitation in people less than 45 years of age.

4.    Back pain is the 2nd most frequent reason for physician visits, the 5th ranking reason for hospital admissions, and is the 3rd most common cause for surgical procedures.

5.    About 2% of the US workforce receives compensation for back injuries annually.

6.    Similar statistics exist for other countries, including the UK and Sweden.

So, what are the common links as to why back pain is so common? 

One reason has to do with the biomechanics of the biped – that is, the two legged animal. When compared to the 4-legged species, the vertically loaded spine carries more weight in the low back, shows disk and joint deterioration and/or arthritis much sooner, and we overload the back more frequently because, well, we can!

We have two free arms to lift and carry items that often weigh way too much for our back to be able to safely handle. We also lift and carry using poor technique. Another reason is anatomical as the blood supply to our disks is poor at best, and becomes virtually non-existent after age 30. That makes healing of disk tears or cracks nearly impossible. Risk factors for increased back injury include heavy manual lifting requirements, poor or low control of the work environment and prior incidence of low back pain.

Other risk factors include psychosocial issues such as fear of injury, beliefs that pain means one should not work, beliefs that treatment or time will not help resolve a back episode, the inability to control the condition, high anxiety and/or depression levels and more.

Because there are so many reasons back problems exist, since the early 1990’s, it has been strongly encouraged that we as health care providers utilize a “biopsychosocial model” of managing those suffering with low back pain, which requires not only treatment but proper patient education putting to rest unnecessary fears about back pain.

If you are one of the lucky ones who does not experience back pain, this is the time to take proactive steps to decrease the chance of it happening later in life.  Functional exercises (those that involve the whole body) can strengthen your back muscles and abdominal/torso muscles ("the core") and can improve their responsiveness to varying loads (make them work better when lifting something heavy or bending at the waist).  A certified personal trainer can guide you in the right direction.

If you are experiencing back pain, a combination of spinal manipulation, massage, somatic and rehabilitative exercises can bring you back to normal.

For more information, call Dr. Perez at (925) 855-5525.

Renae Wilber July 19, 2012 at 10:45 pm
You didn't mention the importance of an MRI. Back pain can often times be cancer of the bone, which through spinal manipulation, etc., can severely damage a back if an accurate prognosis is missed. I met one lady at Stanford who had initially been sent to a chiropractor for back pain (by another facility). The chiropractor only served to fracture her spine, at which after a trip to emergency and an MRI it was found that her breast cancer had spread to her bone. Unfortunately, her bone was fractured as the chiropractor attempted to "make adjustments" to improve her back pain. Always find the source before the treatment is rendered.
Dan Perez July 20, 2012 at 08:46 pm
Yes, of course, there are what we call "red flags" in any kind of pain that warrant a trip to the hospital. A proper work up should have prevented that unfortunate incident from happening. In general, a history of cancer, cardiovascular disease (especially stroke, atherosclerosis, or aneurysm), or signs of fever along with the back pain are conditions where extra caution should be exercised. Thanks for pointing that out.
Renae Wilber July 21, 2012 at 12:22 am
She did not know that she had cancer, nor that it had spread to her bone. How would you have found that prior to manipulating her spine? It was in fact the chiropractor who fractured her spine who put her in the emergency room. Do chiropractor's use MRIs to deter malpractice of this sort? X-rays typically do no good. What would you have done in a "proper workup"?
Dan Perez August 2, 2012 at 04:11 pm
You said another "facility" referred her to a chiropractor. This was most likely her primary care physician. If this was the case, the PCP failed to do a proper work up, which means taking a complete history, doing a thorough exam, and ordering special tests like a blood test and x-ray. Most doctors seeing patients complaining of lower back pain tend to automatically believe it is musculoskeletal in origin, and prescribe muscle relaxants, home care, or physical therapy. This is not surprising since most cases of lower back pain are of this nature. A very good doctor, however, will start with a clean slate and make sure all bases are covered, and not jump to conclusions. It's customary to first rule out red-flag conditions like I mentioned, but a lot of times this is glossed over. Basically, unrelenting pain that does not improve with rest, sleep, ice, and meds; weakness/wasting, and sometimes loss of appetite are signs of cancer. X-rays can detect bone cancer, so that should have been ordered. I very often refer out patients for MRI and X-ray, especially if I suspect a herniated disc, cancer, or other pathology. Once cleared, then manual therapies like PT and chiropractic can be attempted.
Renae Wilber August 2, 2012 at 10:07 pm
That's really an informative response. You are absolutely right, her primary care physician should have been on top of it before referring her out and obviously missed it for a long enough time to land her at Stanford with very progressive breast cancer which had spread to her bones. Thanks for such a thoughtful and informative response!

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I too just noticed the sign. I'm wondering if they just recently changed the picture which is whyRead More we are all just noticing it if indeed it truly has been there since the 80s.......I certainly hope that it is an old sign and that this is not the beginning of other billboard signs lining our 680 corridor.
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