What is mechanical low back pain?

Updated: Mar 06, 2018
  • Author: Everett C Hills, MD, MS; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Mechanical low back pain (LBP) remains the second most common symptom-related reason for seeing a physician in the United States. Of the US population, 85% will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks.

For individuals younger than 45 years, mechanical LBP represents the most common cause of disability and is generally associated with a work-related injury. For individuals older than 45 years, mechanical LBP is the third most common cause of disability, and a careful history and physical examination are vital to evaluation, treatment, and management. [1]

Numerous treatment guidelines have been written regarding the evaluation, treatment, and management of LBP. [2, 3] Perhaps the most widely reviewed (and controversial) guideline was published in 1994 by the Agency for Health Care Policy and Research titled "Acute Lower Back Problems in Adults: Clinical Practice Guidelines." [4]

At the beginning of the 21st century, 750 national and international organizations partnered to create the Bone and Joint Decade (2002-2011). [5] This initiative involves patient and professional health care organizations, government agencies, and industries working collaboratively to increase the awareness of bone and joint diseases while increasing the information and research to address this major health care issue. Because 1 in 5 Americans will be age 65 or older by 2030, 65 million people (20% of the total population) will be affected by musculoskeletal impairments, with LBP ranking among the most common problems. Already, total direct and indirect costs for the treatment of LBP are estimated to be $100 billion annually.

The physiatrist represents one type of medical specialist who can evaluate, diagnose, treat, and manage LBP by using medical and nonsurgical procedures and interventions. The physiatrist may have the best functional understanding of all specialists in the treatment and management of mechanical LBP. [6, 7]


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