Bones, Joints, and Muscle Disorders
LOW BACK PAIN
Low back pain, one of the most frequent of musculoskeletal disorders, affects up to 80 percent of people sometime in their lives, and in any given month 20 to 30 percent of adults have an episode. Generally, the pain is in the lower back on one or both sides, occasionally extending into the buttocks or thighs. In most persons the cause of back pain is unknown. It may arise from any number of pain-sensitive structures in the lumbar spinal column, including joints, ligaments, muscles, and soft tissues.
Generally, back pain is episodic, with half of the episodes remitting within a week and 90 percent going away within a month. Back pain of long duration, which occurs in only a small minority of patients, accounts for most of the societal cost of low back pain and much of the work loss and disability. Persons at high risk of low back pain include those between age twenty and forty, and those whose jobs involve physical labor—especially lifting, pushing, or pulling heavy objects, or twisting during lifting. Truck drivers are the occupational group who experience the most back pain. Another risk factor for low back pain is cigarette smoking, and poor physical fitness may also contribute to its occurrence. The high rate of back pain in particular occupations has suggested
Table 1
| The Most Common Musculoskeletal Disorders in Adults Aged 45 Years And Older: Point Prevalence in Adult Populations in Western Europe and the U.S. |
| SOURCE: Felson, D. T. "Epidemiology of the Rheumatic Diseases." Arthritis & Allied Conditions, W. Koopman, ed. New York: Lippincott, Williams and Collens, 2000. |
| Extremely common (prevalence > 5%) |
| Low back pain |
| Osteoarthritis |
| Tendinitis or bursitis |
| Common (prevalence 0.5-5%) |
| Gout |
| Fibromyalgia |
| Rheumatoid arthritis |
that altering work tasks may be a successful way to prevent episodes of back pain. Indeed, industry training programs have achieved success in lessening the rate of low back pain in some occupations.
OSTEOARTHRITIS
Osteoarthritis is the most common form of arthritis and, depending on how it is defined, affects 10 to 20 percent of all adults and a much larger percentage of the elderly.
