“Back trouble” factoids….

Inheritability of back pain may be as high as 68% with inheritable factors including disc degeneration (statistically accounting for up to 75%) and tendency toward psychological distress.  Four studies draw the conclusion muscle strength and general fitness appear to be of little significance and there is no persuasive evidence flexibility, gender or leg length inequality play a meaningful role. Taller men do have a higher prevalence of certain disc problems presumable due to the fact tall people lift weights at the end of longer lever arms. Several studies have concluded there is “moderate evidence” that lumbar flexibility, bodyweight and straight leg raise have no predictive value for future LBP. Additionally recent studies also show moderate evidence that general cardiorespiratory fitness has no predictive value for future LBP.  And has been mentioned in other blogs MRI and radiographs hold NO value in predicting future LBP.

A relatively recent systematic review (Pincus et al Spine 2002) of psychological factors as predictors of “unfavorable outcomes” concluded there is “good evidence” to implicate distress/depressive mood and somatization in development of chronicity.

And there is also “strong evidence” psychological factors play an important role in persisting symptoms. A workers’ belief regarding their work having caused their pain and their expectations of inability to return (‘yellow flags’) are of particular importance.