For low back pain the evidence indicates:
Back pain to be a common condition with a broadly consistent pattern from early teenage years to old age.
The course of most low back pain is usually a recurrent, intermittent complaint.
There is a blurring of the distinction between:
phases of extremely painful (acute) pain, or
where there are phases of no pain and phases of pain, or
long- term persistent (chronic) low back pain.
The idea that work is usually a “toxic” inﬂuence on the back has little evidence to support it.
The bio-mechanical/“injury model” of low back pain is largely inappropriate. It may be relevant for many people and their presenting problem, but for many others, it is unhelpful. This is because it does not take account of important psychological and social influences we all have and experience in our lives.
The notion that back pain can be easily prevented is seriously unrealistic.
For working-age people early return to work, even if the back remains troublesome, is an important health-giving goal.
Long-term persistent (chronic) back pain is not an isolated symptom focussed on the lower back. It quite often reflects an inability to manage the pain itself. Much research evidence for this is becoming a practical reality for developing an education-based support for each patient as an individual. (In years past, doctors frequently said “you must learn to live with your pain”. They never offered thought as to why the patient had the problem or how they were suppose to live with it)!