Spinal Mechanical Load: A risk factor for non-specific low back pain?

In 1938 Gilcreest wrote: ‘There is no condition which produces more disability and economic loss and, therefore, is so costly to industry as low back pain’ [1]. Seventy years after this statement, a large number of systematic reviews are published concerning the effectiveness of treatments for low back pain [2,3,4,5,6,7,8]. Despite this large amount of evidence regarding the management, low back pain remains a major health problem worldwide [9] with a reported 1-year prevalence ranging from 15% to 40% in a general population [10]. About 85% of the cases with low back pain are labelled as non-specific, i.e. not attributed to recognisable pathology [11]. Acute (i.e. complaints lasting 0-6 weeks) non-specific low back pain is considered a benign self-limiting disease, with a recovery rate of 80-90% within six weeks in the open population, irrespective type of management or treatment [12]. However, recurrence rates are reported as high as 50% in the following 12 months. Therefore, acute non-specific low back pain should be viewed as a persistent condition in many patients [13,14]. Primary as well as secondary prevention might be beneficial in the management of acute low back pain. For prevention, knowledge of the risk factors is essential. Although epidemiological studies have identified many individual, psychosocial and occupational risk factors for the onset of low back pain, their independent prognostic value is usually low [15].

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