Low back pain: advancements and challenges in its prevention and management

Abstract

Low back pain is defined as episodic pain that is localised to between the lower edge of the ribs and the sacral region. It is a highly prevalent and debilitating condition that is attributed to a range of aetiologies. Approximately 80% of adults experience at least one episode of low back pain over the course of their life, while between 10% and 40% develop a chronic form that is defined as that which persists for more than 12 weeks. Multiple factors are linked to the development of low back pain, including disc herniation, spinal stenosis, arthritis, ankylosing spondylitis, spondylolisthesis, cauda equina syndrome, osteoporosis, vertebral factures and even vertebral infections and tumours, among other things. Nonetheless, no single specific cause is identified in the majority of cases and the pain is usually classified as non-specific chronic LBP or, more recently, chronic primary LBP. Recent studies have revealed that no significant differences exist in the degenerative alterations of the spinal column between people with and without low back pain. In many cases, this implies that the pain cannot be clearly attributed to these structural factors. LBP currently stands as the main cause of disability and employee absenteeism in our country, with an economic cost estimated to stand at approximately nine billion euros per year.