Epidemiology and Natural History of Low Back Pain

Low back pain is considered acute if its duration is one month or less, whereas chronic low back pain is defined by symptoms lasting 2 months or longer. There is a wide range of causes of acute and chronic low back pain. Common causes of acute low back pain include lumbar strain or sprain, osteoporotic fracture of the vertebra or pelvis, and abdominal aortic aneurysms. Common causes of chronic, or sub-acute low back pain are degenerative disc and joint disease, malignancy, fibromyalgia, polymyalgia rheumatica, Parkinson's disease, Paget's disease, or diffuse idiopathic skeletal hyperostosis. Low back pain is a considerable public health problem that can affect people of any age and socioeconomic class. Understanding the natural history and clinical course of any disease is essential in guiding the decisions about caring for and preventing the disease. However, there is very little known about the natural history of low back pain. Risk factors for low back pain may be genetic, acquired or due to the combination of an individual's interaction with the environment. Prospective studies of predetermined risk factors should be used in the future to more accurately assess their influence on developing low back pain. With enormous economic costs of low back pain exceeding $100 billion annually, it is of the utmost importance to create strategies for preventing these disorders and their consequences.