FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 344:363-370 February 1, 2001 Number 5 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

About two thirds of adults suffer from low back pain at some time. Low back pain is second to upper respiratory problems as a symptom-related reason for visits to a physician.^1,2 There are wide variations in care, a fact that suggests there is professional uncertainty about the optimal approach.^3,4 In addition, there is evidence of excessive imaging and surgery for low back pain in the United States,^5,6,7,8 and many experts believe the problem has been "overmedicalized."^9,10,11 In recent years, magnetic resonance imaging (MRI) has come to be widely used, the roles of exercise and bed rest have been clarified, and . . . [Full Text of this Article]

Causes and Epidemiologic Patterns

Diagnostic Evaluation

Medical History

Physical Examination

Imaging

Evaluation of Older Adults

Natural History

Therapy

Nonspecific Low Back Pain

Herniated Intervertebral Disks

Spinal Stenosis

Chronic Low Back Pain

Prevention

Conclusions

Source Information

From the Departments of Medicine and Health Services and the Center for Cost and Outcomes Research, University of Washington, Seattle (R.A.D.); and the Center for the Evaluative Clinical Sciences and the Department of Surgery, Dartmouth Medical School, Hanover, N.H. (J.N.W.).

Address reprint requests to Dr. Deyo at the Center for Cost and Outcomes Research, University of Washington, Box 358853, Seattle, WA 98195.

References

This article has been cited by other articles:

• Rathmell, J. P. (2008). A 50-Year-Old Man With Chronic Low Back Pain. JAMA 299: 2066-2077 [Abstract] [Full Text]  
• Raspe, H., Hueppe, A., Neuhauser, H. (2008). Back pain, a communicable disease?. Int J Epidemiol 37: 69-74 [Abstract] [Full Text]  
• Haake, M., Muller, H.-H., Schade-Brittinger, C., Basler, H. D., Schafer, H., Maier, C., Endres, H. G., Trampisch, H. J., Molsberger, A. (2007). German Acupuncture Trials (GERAC) for Chronic Low Back Pain: Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups. Arch Intern Med 167: 1892-1898 [Abstract] [Full Text]  
• Gallucci, M., Limbucci, N., Zugaro, L., Barile, A., Stavroulis, E., Ricci, A., Galzio, R., Masciocchi, C. (2007). Sciatica: Treatment with Intradiscal and Intraforaminal Injections of Steroid and Oxygen-Ozone versus Steroid Only. Radiology 242: 907-913 [Abstract] [Full Text]  
• Martell, B. A., O'Connor, P. G., Kerns, R. D., Becker, W. C., Morales, K. H., Kosten, T. R., Fiellin, D. A. (2007). Systematic Review: Opioid Treatment for Chronic Back Pain: Prevalence, Efficacy, and Association with Addiction. ANN INTERN MED 146: 116-127 [Abstract] [Full Text]  
• Roux, C, Priol, G, Fechtenbaum, J, Cortet, B, Liu-Leage, S, Audran, M (2007). A clinical tool to determine the necessity of spine radiography in postmenopausal women with osteoporosis presenting with back pain. Ann Rheum Dis 66: 81-85 [Abstract] [Full Text]  
• Donner-Banzhoff, N., Roth, T., Sonnichsen, A. C, Luckmann, J., Leonhardt, C., Chenot, J.-F, Becker, A., Keller, S., Griffiths, F., Baum, E. (2006). Evaluating the accuracy of a simple heuristic to identify serious causes of low back pain. Fam Pract 23: 682-686 [Abstract] [Full Text]  
• Weinstein, J. N., Tosteson, T. D., Lurie, J. D., Tosteson, A. N. A., Hanscom, B., Skinner, J. S., Abdu, W. A., Hilibrand, A. S., Boden, S. D., Deyo, R. A. (2006). Surgical vs Nonoperative Treatment for Lumbar Disk Herniation: The Spine Patient Outcomes Research Trial (SPORT): A Randomized Trial. JAMA 296: 2441-2450 [Abstract] [Full Text]  
• Baliki, M. N., Chialvo, D. R., Geha, P. Y., Levy, R. M., Harden, R. N., Parrish, T. B., Apkarian, A. V. (2006). Chronic Pain and the Emotional Brain: Specific Brain Activity Associated with Spontaneous Fluctuations of Intensity of Chronic Back Pain.. J. Neurosci. 26: 12165-12173 [Abstract] [Full Text]  
• Ihlebaek, C., Hansson, T. H., Laerum, E., Brage, S., Eriksen, H. R., Holm, S. H., Svendsrod, R., Indahl, A. (2006). Prevalence of low back pain and sickness absence: A ``borderline'' study in Norway and Sweden. Scand J Public Health 34: 555-558 [Abstract]  
• Witt, C. M., Jena, S., Selim, D., Brinkhaus, B., Reinhold, T., Wruck, K., Liecker, B., Linde, K., Wegscheider, K., Willich, S. N. (2006). Pragmatic Randomized Trial Evaluating the Clinical and Economic Effectiveness of Acupuncture for Chronic Low Back Pain. Am J Epidemiol 164: 487-496 [Abstract] [Full Text]  
• Refshauge, K M, Maher, C G (2006). Low back pain investigations and prognosis: a review. Br. J. Sports. Med. 40: 494-498 [Abstract] [Full Text]  
• Siddall, P. J., Stanwell, P., Woodhouse, A., Somorjai, R. L., Dolenko, B., Nikulin, A., Bourne, R., Himmelreich, U., Lean, C., Cousins, M. J., Mountford, C. E. (2006). Magnetic resonance spectroscopy detects biochemical changes in the brain associated with chronic low back pain: a preliminary report.. Anesth. Analg. 102: 1164-1168 [Abstract] [Full Text]  
• Brinkhaus, B., Witt, C. M., Jena, S., Linde, K., Streng, A., Wagenpfeil, S., Irnich, D., Walther, H.-U., Melchart, D., Willich, S. N. (2006). Acupuncture in patients with chronic low back pain: a randomized controlled trial.. Arch Intern Med 166: 450-457 [Abstract] [Full Text]  
• Foss, J. M., Apkarian, A. V., Chialvo, D. R. (2006). Dynamics of Pain: Fractal Dimension of Temporal Variability of Spontaneous Pain Differentiates Between Pain States. J. Neurophysiol. 95: 730-736 [Abstract] [Full Text]  
• Sodha, S., Ring, D., Zurakowski, D., Jupiter, J. B. (2005). Prevalence of Osteoarthrosis of the Trapeziometacarpal Joint. JBJS 87: 2614-2618 [Abstract] [Full Text]  
• Dionne, C. E., Bourbonnais, R., Fremont, P., Rossignol, M., Stock, S. R., Larocque, I. (2005). A clinical return-to-work rule for patients with back pain. CMAJ 172: 1559-1567 [Abstract] [Full Text]  
• Sieper, J, Rudwaleit, M (2005). Early referral recommendations for ankylosing spondylitis (including pre-radiographic and radiographic forms) in primary care. Ann Rheum Dis 64: 659-663 [Abstract] [Full Text]  
• Apkarian, A. V., Sosa, Y., Sonty, S., Levy, R. M., Harden, R. N., Parrish, T. B., Gitelman, D. R. (2004). Chronic Back Pain Is Associated with Decreased Prefrontal and Thalamic Gray Matter Density. J. Neurosci. 24: 10410-10415 [Abstract] [Full Text]  
• Sigmundsson, F. G., Andersen, P. B., Schroeder, H. D., Thomsen, K. (2004). Vertebral Osteonecrosis Associated with Pancreatitis in a Woman with Pancreas Divisum. A Case Report. JBJS 86: 2504-2508 [Full Text]  
• Licciardone, J. C. (2004). The Unique Role of Osteopathic Physicians in Treating Patients With Low Back Pain. JAOA: Journal of the American Osteopathic Association 104: 13S-18S [Abstract] [Full Text]  
• Liszka-Hackzell, J. J., Martin, D. P. (2004). An Analysis of the Relationship Between Activity and Pain in Chronic and Acute Low Back Pain. Anesth. Analg. 99: 477-481 [Abstract] [Full Text]  
• Ring, D., Guss, D., Malhotra, L., Jupiter, J. B. (2004). Idiopathic Arm Pain. JBJS 86: 1387-1391 [Abstract] [Full Text]  
• Rudwaleit, M, van der Heijde, D, Khan, M A, Braun, J, Sieper, J (2004). How to diagnose axial spondyloarthritis early. Ann Rheum Dis 63: 535-543 [Abstract] [Full Text]  
• Weinstein, J. (2004). Absent from Work: Nature versus Nurture. ANN INTERN MED 140: 142-143 [Full Text]  
• Ihlebaek, C., Eriksen, H. R. (2003). Are the ``myths'' of low back pain alive in the general Norwegian population?. Scand J Public Health 31: 395-398 [Abstract]  
• Ghafoor, V. L. (2003). Treatment of Chronic Pain. Journal of Pharmacy Practice 16: 249-260 [Abstract]  
• Ghafoor, V. L. (2003). Management of Painful Conditions in the Elderly. Journal of Pharmacy Practice 16: 276-283 [Abstract]  
• Jarvik, J. G., Deyo, R. A. (2002). Diagnostic Evaluation of Low Back Pain with Emphasis on Imaging. ANN INTERN MED 137: 586-597 [Abstract] [Full Text]  
• Deyo, R. A. (2002). Diagnostic Evaluation of LBP: Reaching a Specific Diagnosis Is Often Impossible. Arch Intern Med 162: 1444-1447 [Full Text]  
• Haig, A. J., Wallbom, A., Hill, P. G., Deyo, R. A., Weinstein, J. N. (2001). Low Back Pain. NEJM 344: 1644-1645 [Full Text]