Key facts and checkpoints

• Back pain accounts for at least 5% of all presenting problems in general practice in Australia and 6.5% in Britain. 1

• In the United States it is the commonest cause of limitation of activity under the age of 45. 2

• Approximately 85% of the population will experience back pain at some stage of their lives, while 70% of the world's population will have at least one disabling episode of low back pain in their lives. 2

• At least 50% of these people will recover within 2 weeks and 75% within 1 month, but recurrences are frequent and have been reported in 40-70% of patients.

• The most common age groups are the 30s, 40s and 50s, the average age being 45 years.

• The most common cause of back pain is a minor strain to muscles and/or ligaments, but people suffering from this type of back pain usually do not seek medical treatment as most of these soft tissue problems resolve rapidly.

• The main cause of back pain presenting to the doctor is dysfunction of the intervertebral joints of the spine due to injury, also referred to as mechanical back pain (at least 70%).

• The causes of this dysfunction are disorders of the facet joints and internal disruption of the intervertebral disc, the exact balance being uncertain.

• The second most common cause of back pain is spondylosis (synonymous with osteoarthritis and degenerative back disease). It accounts for about 10% of cases of low back pain.

• L5 and S1 nerve root lesions represent most of the cases of sciatica presenting in general practice. They tend to present separately but can occur together with a massive disc protrusion.

• An intervertebral disc prolapse has been proven in only 6-8% of cases of back pain. 2

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