Low back pain (LBP) is the commonest cause of disability in persons under 46 years of age.1 

LBP remains one of the most difficult challenges that face health care providers, as there are 9 important factors that compound the ability to manage, minimize the cost and predict its outcome:

  • Low back pain is a symptom and not a disease yet it remains the commonest used term to describe the diagnosis.2 

  • Low back pain can be caused due to injury or disease process.2 

  • There are many diseases in systems other than musculo-skeletal systems that cause LBP.2 

  • Most types of back pain closely mimic each other.2 

  • Part of the problem is due to the fact that the region of the low back is extremely complex, both anatomically and functionally.3 

  • Another difficulty is the inability to objectively define a measurement for pain. 3 

  • A large part of the problem is the cultural need to medicalize LBP, linking the symptoms to radiological abnormalities requested by physicians. 2 

  • Physicians' insufficient understanding of the topic and its management leading to patient advocacy.2,3 

  • Poor medical results of occupationally related LBP in institutions unprepared to deal with this problem.2,3 

Many psychological factors are thought to be causative in development, exacerbation and/or maintenance of chronic LBP.4 

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