Epidemiology of back disorders: prevalence, risk factors, and prognosis.
OBJECTIVE
This article reviews some of the advances that have taken place in understanding back disorders, with a particular emphasis on low back pain, as this area has been most represented in the literature in the preceding year (September 2003 to September 2004).


RESULTS
Epidemiological studies continue to provide insights into the prevalence of back pain and have identified many individual, psychosocial, and occupational risk factors for its onset. Psychological factors have an important role in the transition from acute to chronic pain and related disability. Recent advances show that there is a significant genetic effect on severe low back pain in the community. Data emerging from candidate gene studies show an association between lumbar disc disease and mutations of genes encoding the alpha-2 and alpha-3 subunits of collagen IX.


CONCLUSIONS
Back pain is among the most common conditions for which patients seek medical care. Interventions based on behavioral and cognitive principles and exercise programs are effective in improving disability in chronic back pain. Although progress has been made in understanding the role of genetic mutations in disorders such as lumbar disc disease, further investigation of the interaction between genetic and environmental factors such as physical stress is needed.
Manek
Nisha J
NJ
Division of Rheumatology, Mayo Clinic, Rochester, Minnesota 55905, USA. manek.nisha@mayo.edu
MacGregor
A J
AJ
D003906:Developing Countries; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012219:Rheumatology / Q000639:trends; D012307:Risk Factors; D013122:Spinal Diseases / Q000150:complications / Q000473:pathology; D014481:United States / Q000453:epidemiology