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Introduction

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It’s nothing major but it’s just something I can’t play with right now. 

Professional golfer Michelle Wie speaking about her lumbar disk injury, which caused her to drop out of an LPGA tournament in November, 2010. Quoted by Beth Ann Baldry from Golfweek

Low back pain is an extremely common symptom in both the general population and also among sportspeople. In this chapter we outline some salient epidemiological data and detail a clinical perspective of managing low back pain before discussing the evaluation and treatment of back pain.

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Epidemiology

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Back pain affects up to 85% of the population at some time in their lives. The vast majority (90%) improve over a three-month period, but nearly 50% will have at least one recurrent episode. The estimated annual cost of low back pain in the US is over US$40 billion. Low back pain is the most common disability in those under the age of 45, and the most expensive health care problem in those between the ages of 20 and 50. Back problems account for a significant percentage (25% in the US) of workers compensation claims, although the incidence of work-related low back pain varies considerably among countries (e.g. it is much lower in Scandinavia than in the US).

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Considerable research has been undertaken investigating the risk factors for low back pain; these are summarized in Table 26.1.

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Table Graphic Jump Location
Table 26.1

Risk factors associated with low back pain (LBP)

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Clinical perspective

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As with neck pain, it is often not possible to make a precise anatomical and pathological diagnosis. However, this does not prevent management and treatment. In the majority of cases of low back pain, the principles of management depend on careful assessment to detect any abnormality, and then appropriate treatment to correct that abnormality. The anatomy of the low back is shown in Figure 26.1. The lumbar spine pain generators ...

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