Facts about Back Pain

Back pain results in more lost work productivity than any other medical condition. It is the second leading cause of missed workdays (behind the common cold).

In their lifetime, 70% of people in the United States will have some kind of back pain. Each year 1 person in 5 will have it.

Back pain is more common in men than women.

Back pain is more common among whites than among other racial groups.

Most back pain occurs among people aged 45–64 years.

Each year 13 million people go to the doctor for chronic back pain. It is estimated that the condition leaves 2.4 million Americans chronically disabled and another 2.4 million temporarily disabled.

Discussion of back pain has been found on Egyptian papyrus dating 3500 years ago. As the centuries went by, thousands of physicians have discussed it and recommended treatments.

The National Center for Health Statistics states 14% of all new visits to doctors are for low back pain.

About 25% of people who have back pain have a herniated disk. This is commonly called sciata because the problem once was believed to stem from pressure on the sciatic nerve. Sciatica causes pain to radiate through your buttocks into one or both legs.

A disk acts as a shock absorber for your spine. It is made up of a tough outer ring of cartilage with an inner sac filled with a jellylike substance. When a disk herniates, the jellylike nucleus pushes through the harder outer ring (annulus), sometimes putting pressure on a nerve root. However, not all disc herniations compress a nerve , and therefore cause pain.

Between the ages of 14 and 34 years, 90 percent of the discs were found to be normal.

At ages 35 to 45, degeneration was evident in 75 percent.

After the age of 46, every single fifth lumbar disc was degenerated.

And only 25 percent of the fourth lumbar discs were normal.

Surgery

As with other causes of back pain, doctors first attempt non-operative treatment for a herniated disc. But surgery often produces gratifying relief.

Surgery is reserved for those patients that have intolerable pain that is unresponsive to non-operative means. Also surgery is often recommended for patients with nerve damage, for example, numbness or loss of strength in the effected limb.

Surgery may be considered for anyone with frequently recurring sciatica, usually if the pain interferes with your ability to work or do daily activities.

The decision to have surgery should be a joint decision you make with your doctor.

If the deficit produced by loss of nerve function is severe—you cannot bend a knee or move a foot—surgery is an option. However, many people may not regain full nerve function, even after surgery, making early intervention preferable.

In the US, some 450 cases of herniated disk per 100,000 require surgery.

The average age for surgery is 40-45 years.

Men are twice as likely to need surgery as women.

More than 95% of disk operations are performed on the fourth and fifth lumbar vertebrae.

The trends in surgery are towards minimal access approaches, such as microdiscectomy, percutaneous procedures, and image guided stereotactic surgery.