Back pain from the epidemiological point of view |
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Authors: | T Schochat W H Jäckel |
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Institution: | Albert-Ludwigs-Universit?t, Medizinische Universit?tsklinik, Rheumaepidemiologie und Rehabilitation, Freiburg i.Br., XX
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Abstract: | Summary
In the last decades back pain has reached dramatic proportions in industrialized countries. Disorders of the back are nowadays
the leading cause of direct and indirect health care costs. Accurate prevalence estimates are needed to serve as a basis for
health care evaluations. A review of epidemiologic studies in the general population reveals that back pain has reached a
prevalence of 40 % for current pain. 7 to 18 % are “frequently”, “often”, “daily” or “constantly” affected. 75 % of the adult
population suffers from back pain during the last year. 80 to 90 % of the adult population in industrialized countries experience
back pain ever. Gender specific differences are only present in severe, chronic forms which are more often experienced by
women. Back pain has a prevalence maximum at 50 to 64 years. Older persons display lower prevalence estimates. The prevalence
maximum in men is one decade earlier than in women. There are several potential explanations for this prevalence pattern that
are discussed in the article. Back pain can be classified by location, temporal characteristics, pain intensity and pain history.
Currently, for none of these dimensions generally accepted, uniformly employed and validated definitions are available. In
most of the industrialized countries back pain is one of the most expensive symptoms. 75–90 % of the direct and indirect health
care costs were caused by those 5–10 % of patients who are disabled. As predictors of back pain a history of back pain and
job satisfaction play by far a more important role than the extensively studied mechanical factors. For a first episode of
back pain the prognosis is favorable. If the pain persist for more than three months the prognosis is unfavorable. After six
months of absenteeism because of back pain more than half of the afflicted never return to work. Rarely back pain is present
as a single symptom. In more than 80 % back pain is associated with pain in at least one joint. It remains to be studied if
back pain may be viewed as an entity or as part of a more complex pain syndrome.
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Keywords: | Epidemiology • Rheumatic disease epidemiology • Back pain • Prevalence • Population studies |
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