Epidemiological Aspects of Back Pain

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Abstract
Definition of back pain is one of the main problems associated with epidemiological studies of back pain which is generally acknowledged to be a disabling but not fatal condition. Certainly the sickness absence attributable to it is substantial though one can argue interminably about the exact number of days lost per thousand men at work, principally because of poor certification and lack of agreement on definition. Some personal characteristics such as age, weight, and structural defects of the spinal column do seem to predispose to back pain. Apart from the rather blunt instrument of secondary prevention either by pre-employment medical examination or by routine screening during employment (particularly of those doing heavy work) it is doubtful if any preventive measures can be undertaken in relation to these factors. This doubt is accentuated because past experience has shown that specificity of screening tests in relation to them is of a very low order (Kosiak et al., 1966; 1968). On the other hand environmental factors, such as effort at work and proper posture may be amenable to preventive measures. However, such measures are likely to be costly and it is essential that doctors and others in this field are confident that the tools of measurement they are using are sufficiently reliable to enable them to base their recommendations for preventive measures on a sound footing.

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