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By Robin A. McKenzie, Stephen May
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Additional info for The Lumbar Spine: Mechanical Diagnosis and Therapy 2nd Edition (2 Volume Set)
Example text
1990) One review of the literature found that between 7% and 18% of populaLion samples that have been studied are affected frequemly, daily or constantly by back pain (Raspe 1993). Persistent sympLoms have been reponed by about 40% and l ongstanding, disabl ing backache by abouL 10% of all those who suffer from the problem (Croft et al. 1997; Evans and Richards 1996; Fordyce 1995; 113 1 41 C HA P TE R O N E T H E LUM BA R S P I N E: M EC H A N ICAL D I AG N OS I S & THE RAPY Waddell 1994; Linton et aL 1998; Szpalski et al.
6 5 - 0 . 9 3% o f total N H S spending (Klaber Moffett e t al. 1 99 5 ) . A more recent estimate of t h e direct health care costs of back pain i n t h e U K for 1 998 put the cost at £1 ,632 million (Maniadakis and Gray 2000). In the US, medical care costs have been esti mated at between $8 and $ 1 8 billion CShekelle et al. 1995) T h e medical costs o f back pai n , however, are only a part of t h e whole cost of the problem that society pays. Indirect costs, such as disability or compensation payments, production losses at workplaces and informal care , dwarf the amount that is spent directly o n patient care.
The strongest known risk factor for developing back pain is a h istory of a previous episode (Croft et al. 1 997; Shekel le 1 997; Smedley et al. 1 997) The chance of haVing a recurrence of back pain a fter a f irst e p isode is greater than 5 0% . Many recurrences are common and more than one-third of the back pain population have a l ong-term problem (Cro ft et al. 1 9 97; Evans a n d R i c h a rds 1 9 9 6; Wadd e l l 1 9 94; 111 121 C H A PTE R O N E T H E LUM BA R S P I N E: M EC H A N ICAL D I AG NOSIS & T H E RA PY Papageorgiou and Rigby 1 99 1 ; Linton et al.