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Epidemiology, etiology, diagnostic evaluation, and treatment of low back pain

Low back pain is a common medical problem but has decreased in frequency in the occupational setting over the past decade. The weather affects low back pain but to a minor degree. Physical factors, as well as job satisfaction, play a role in the development and perpetuation of low back pain. In contradistinction to previous measurements, intradiscal pressure has been determined in vivo to be greater in the standing than the sitting position. Adenovirus-mediated gene transfer to nucleus pulposus cells may be the initial stage of a new form of therapy for degenerative disc disease. Bed rest is not more helpful than activity as tolerated for the treatment of sciatica. The outcome of spinal stenosis surgery is more closely associated with the patient’s perception of improvement than with the degree of canal narrowing.