An early screening and intervention model for acute and subacute low back pain

Low back pain (LBP) is one of the most common causes of disability. Volinn (1997) identified seven epidemiological investigations conducted in Belgium, Germany, Great Britain and Sweden that reported on the point prevalence of LBP. By weighting the percentages by the sample size, and then aggregating across studies, it was found that the rates of LBP in these countries averages approximately 34%. This is almost twice that reported in surveys conducted in less developed countries. Also, as Mayer and Gatchel (1988) had originally reviewed, it is the number one cause of disability of persons under age 45. Over this age, it is the third leading cause of disability, becoming progressively less of a factor during later years when function and productivity become of less concern than survival. It should also be noted that back-related disorders represent the most prevalent source of disability in the U.S. military (Feuerstein, Berkowitz & Peck, 1997). Indeed, in the U.S, of all the occupational musculoskeletal disorders, the most research attention to date has been dedicated to LBP disability, because this is the most expensive benign condition in industrialized countries (Volinn, 1997). It has been estimated that, in any one year, about 3-4% of the population in all industrialized countries has a temporarily disabling LBP episode, and that more than 1% of the working age population is "totally and permanently disabled" by this problem. From a financial point of view, it is one of the most costly problems in the North American workplace (Krause & Ragland, 1994). An even more startling trend is the disproportionate increase in LBP disability as measured against population growth. For example, Frymoyer and Cats-Baril (1991) had earlier reported LBP disability increasing at a rate 14 times the population-growth from1957 to 1976. This trend is continuing to this day.