Low Back Pain

In the context of this book, among the numerous factors that cause low back pain, emphasis should be placed on chronic overuse of the lumbosacral area, which manifests itself in some occupations and in professional and nonprofessional athletes. For this reason, we are including cases of low back pain resulting from excessive chronic overuse of the lumbosacral area whose clinical picture corresponds to that of overuse syndromes. This includes some forms of spondylolysis and spondylolisthesis, low back pain in gymnasts, low back pain in some cases of scoliosis and kyphosis, and myofibrositis. Low back pain is the ailment of the century in modern, technological, highly advanced societies. Viewed from a statistical point of view, all adults suffer from low back pain at least three times in their life. This, of course, also implies that out of three adults, one will suffer nine times in his or her lifetime. According to some statistics, between 50 and 80% of the population in developed industrial countries suffers, or has suffered, from low back pain.41 The diagram of strain placed upon the lumbal vertebrae in various positions of the body clearly indicates that the frequency of low back pain in modern societies results in part from the way of life and work habits practiced in these societies59,82 (Figure 6.1). Loss resulting from absence from work and cost of treatment for low back pain is enormous. To illustrate this, we will cite two examples. The first comes from the U.S. where in one calendar year, loss resulting from low back pain treatment and absence from work was approximated at $14 billion. This is the reason why innovative approaches to prevent and treat low back pain in workers are mandatory. The sports medicine approach for aggressive rehabilitation offers a possible solution.40 The other example comes from the U.K. where in 1 year the number of working days lost because of low back pain exceeded £13 million. This clearly indicates that low back pain is also a socioeconomic problem.35,60

Low back pain is a term used to describe subjective feelings of pain and tenderness felt in the lumbar or, generally speaking, lower spine. As the term implies, the essence of this syndrome lies in the subjective feeling of pain, which can be of different intensity suffered by patients in a very individual manner. A variety of terms are used to describe this painful condition. Lumbago is an old expression used to describe acute pain in the lumbar spine area. Today the term painful lumbar syndrome is preferred and generally used to describe the same condition. The painful lumbar syndrome can be of vertebral origin, meaning the pain manifests itself exclusively in the area in which it originates-in other words, in the lumbar spine area. If painful symptoms manifest themselves in regions far from the spine, e.g., in the lower extremities, the term vertebrogenic painful lumbar syndrome is applied (e.g., lumboischialgia).