What low back pain is and why we need to pay attention

Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population inc...

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Published in:	The Lancet (British edition) Vol. 391; no. 10137; pp. 2356 - 2367
Main Authors:	Hartvigsen, Jan, Hancock, Mark J, Kongsted, Alice, Louw, Quinette, Ferreira, Manuela L, Genevay, Stéphane, Hoy, Damian, Karppinen, Jaro, Pransky, Glenn, Sieper, Joachim, Smeets, Rob J, Underwood, Martin, Buchbinder, Rachelle, Cherkin, Dan, Foster, Nadine E, Maher, Chris G, van Tulder, Maurits, Anema, Johannes R, Chou, Roger, Cohen, Stephen P, Menezes Costa, Lucíola, Croft, Peter, Ferreira, Manuela, Ferreira, Paulo H, Fritz, Julie M, Gross, Douglas P, Koes, Bart W, Öberg, Birgitta, Peul, Wilco C, Schoene, Mark, Turner, Judith A, Woolf, Anthony
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 09.06.2018 Elsevier Limited
Subjects:	Adult Aged Attention Back pain Children Chiropractic medicine Comorbidity Cost of Illness Cost-Benefit Analysis - methods Delivery of Health Care - economics Delivery of Health Care - statistics & numerical data Disability Disabled Persons - psychology Disabled Persons - statistics & numerical data Female Geriatrics Higher education Humans Income Local culture Low back pain Low Back Pain - complications Low Back Pain - epidemiology Low Back Pain - etiology Low Back Pain - pathology Low income areas Low income groups Male Malignancy Middle Aged Older people Pain Pain perception Public health R&D Recurrence Research & development Sick leave Smoking Social Class Socioeconomics Systematic review Vertebrae
ISSN:	0140-6736, 1474-547X, 1474-547X
Online Access:	Get full text
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Abstract	Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause—eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem.
AbstractList	Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause—eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem. Summary Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause—eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem. Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem.Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem.
Author	Turner, Judith A Hancock, Mark J Smeets, Rob J Foster, Nadine E Öberg, Birgitta Cherkin, Dan Woolf, Anthony Genevay, Stéphane Pransky, Glenn van Tulder, Maurits Underwood, Martin Croft, Peter Peul, Wilco C Hartvigsen, Jan Hoy, Damian Anema, Johannes R Karppinen, Jaro Maher, Chris G Schoene, Mark Fritz, Julie M Kongsted, Alice Menezes Costa, Lucíola Buchbinder, Rachelle Koes, Bart W Ferreira, Manuela L Chou, Roger Louw, Quinette Sieper, Joachim Ferreira, Manuela Cohen, Stephen P Ferreira, Paulo H Gross, Douglas P
Author_xml	– sequence: 1 givenname: Jan surname: Hartvigsen fullname: Hartvigsen, Jan organization: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark – sequence: 2 givenname: Mark J surname: Hancock fullname: Hancock, Mark J organization: Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia – sequence: 3 givenname: Alice surname: Kongsted fullname: Kongsted, Alice organization: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark – sequence: 4 givenname: Quinette surname: Louw fullname: Louw, Quinette organization: Faculty of Medicine and Health Sciences, Physiotherapy Division and Department of Health and Rehabilitation Sciences, Stellenbosch University, Tygerberg, South Africa – sequence: 5 givenname: Manuela L surname: Ferreira fullname: Ferreira, Manuela L organization: Institute of Bone and Joint Research, Sydney Medical School, The University of Sydney, Sydney, Australia – sequence: 6 givenname: Stéphane surname: Genevay fullname: Genevay, Stéphane organization: Division of Rheumatology, University Hospitals of Geneva, Geneva, Switzerland – sequence: 7 givenname: Damian surname: Hoy fullname: Hoy, Damian organization: University of Sydney, Sydney, Australia – sequence: 8 givenname: Jaro surname: Karppinen fullname: Karppinen, Jaro organization: Medical Research Centre Oulu, University of Oulu and University Hospital, Oulu, Finland – sequence: 9 givenname: Glenn surname: Pransky fullname: Pransky, Glenn organization: Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA USA – sequence: 10 givenname: Joachim surname: Sieper fullname: Sieper, Joachim organization: Department of Rheumatology, Charité, Campus Benjamin Franklin, Berlin, Germany – sequence: 11 givenname: Rob J surname: Smeets fullname: Smeets, Rob J organization: Department of Rehabilitation Medicine, Maastricht University, Maastricht, Netherlands – sequence: 12 givenname: Martin surname: Underwood fullname: Underwood, Martin email: m.underwood@warwick.ac.uk organization: Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK – sequence: 13 givenname: Rachelle surname: Buchbinder fullname: Buchbinder, Rachelle – sequence: 14 givenname: Jan surname: Hartvigsen fullname: Hartvigsen, Jan – sequence: 15 givenname: Dan surname: Cherkin fullname: Cherkin, Dan – sequence: 16 givenname: Nadine E surname: Foster fullname: Foster, Nadine E – sequence: 17 givenname: Chris G surname: Maher fullname: Maher, Chris G – sequence: 18 givenname: Martin surname: Underwood fullname: Underwood, Martin – sequence: 19 givenname: Maurits surname: van Tulder fullname: van Tulder, Maurits – sequence: 20 givenname: Johannes R surname: Anema fullname: Anema, Johannes R – sequence: 21 givenname: Roger surname: Chou fullname: Chou, Roger – sequence: 22 givenname: Stephen P surname: Cohen fullname: Cohen, Stephen P – sequence: 23 givenname: Lucíola surname: Menezes Costa fullname: Menezes Costa, Lucíola – sequence: 24 givenname: Peter surname: Croft fullname: Croft, Peter – sequence: 25 givenname: Manuela surname: Ferreira fullname: Ferreira, Manuela – sequence: 26 givenname: Paulo H surname: Ferreira fullname: Ferreira, Paulo H – sequence: 27 givenname: Julie M surname: Fritz fullname: Fritz, Julie M – sequence: 28 givenname: Stéphane surname: Genevay fullname: Genevay, Stéphane – sequence: 29 givenname: Douglas P surname: Gross fullname: Gross, Douglas P – sequence: 30 givenname: Mark J surname: Hancock fullname: Hancock, Mark J – sequence: 31 givenname: Damian surname: Hoy fullname: Hoy, Damian – sequence: 32 givenname: Jaro surname: Karppinen fullname: Karppinen, Jaro – sequence: 33 givenname: Bart W surname: Koes fullname: Koes, Bart W – sequence: 34 givenname: Alice surname: Kongsted fullname: Kongsted, Alice – sequence: 35 givenname: Quinette surname: Louw fullname: Louw, Quinette – sequence: 36 givenname: Birgitta surname: Öberg fullname: Öberg, Birgitta – sequence: 37 givenname: Wilco C surname: Peul fullname: Peul, Wilco C – sequence: 38 givenname: Glenn surname: Pransky fullname: Pransky, Glenn – sequence: 39 givenname: Mark surname: Schoene fullname: Schoene, Mark – sequence: 40 givenname: Joachim surname: Sieper fullname: Sieper, Joachim – sequence: 41 givenname: Rob J surname: Smeets fullname: Smeets, Rob J – sequence: 42 givenname: Judith A surname: Turner fullname: Turner, Judith A – sequence: 43 givenname: Anthony surname: Woolf fullname: Woolf, Anthony
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/29573870$$D View this record in MEDLINE/PubMed
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Copyright	2018 Elsevier Ltd Copyright © 2018 Elsevier Ltd. All rights reserved. Copyright Elsevier Limited Jun 9, 2018
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Snippet	Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly... Summary Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the...
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SubjectTerms	Adult Aged Attention Back pain Children Chiropractic medicine Comorbidity Cost of Illness Cost-Benefit Analysis - methods Delivery of Health Care - economics Delivery of Health Care - statistics & numerical data Disability Disabled Persons - psychology Disabled Persons - statistics & numerical data Female Geriatrics Higher education Humans Income Local culture Low back pain Low Back Pain - complications Low Back Pain - epidemiology Low Back Pain - etiology Low Back Pain - pathology Low income areas Low income groups Male Malignancy Middle Aged Older people Pain Pain perception Public health R&D Recurrence Research & development Sick leave Smoking Social Class Socioeconomics Systematic review Vertebrae
Title	What low back pain is and why we need to pay attention
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Volume	391
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