Work-related low back pain: secondary intervention

A review of the literature indicates that non-specific low back pain is basically an age-related disorder that is affected by differences in occupation, genetics and personal behavior. The cause of low back pain is unknown in most cases, and most of the treatments in routine use are ineffective. There is no evidence that low back pain has decreased in recent years. Consequently, there are a growing number of investigators who believe that efforts at preventing low back pain are futile; that low back pain is an unavoidable consequence of life that will afflict two thirds of the adult population at some point in their lives. These investigators believe that programs aimed at reducing low back disability are likely to be more effective and less costly. Only a small percentage of people with low back pain become disabled, but this small percentage consumes most of the cost. The literature pertaining to the reduction of low back disability is reviewed and discussed. It is concluded that low back disability can be reduced, and that management (not the health care provider) has the primary responsibility for reducing disability. (C) 2003 Elsevier Ltd. All rights reserved.