ABSTRACT
Back pain is one of the most common reasons for patients to present to their GP, and accounts for a majority of chronic disability and incapacity from work. In the UK up to 50 million working days are lost each year. Nearly half a million people receive a long-term state incapacity benefit because of back pain. The causes of back pain are extensive. The prognoses of these conditions are dependent on timely diagnosis and treatment. In the middle of the spectrum there are the systemic and inflammatory conditions that are neither self-limiting nor fatal, requiring further investigations for diagnosis. Prostate cancer is the most common cancer in UK males. Extensive para-aortic lymph node metastases can cause similar back pain. Hormone treatment depends on the fact that, being a sex gland, the prostate is sensitive to circulating levels of testosterone.
