title: Back pain, a communicable disease?
abstract: BACKGROUND
  Back pain (BP) is a frequent disorder affecting currently up to 40% of adults in Western Europe. Most of it is said to be 'non-specific', i.e. lacking an obvious patho-anatomical explanation. It is seldom the consequence of a contagious disease caused by microorganisms. This does not exclude it from being communicable if 'communicable' is to refer to something being transmitted by sharing or exchanging information.
  
  
  OBJECTIVE
  To propose the hypothesis of BP being a communicable disease.
  
  
  RESULTS
  We base our hypothesis on a reanalysis of five German health surveys. They show a wide gap in BP prevalence between West and East Germany early after reunification. The gap consistently decreased to nearly zero in 2003. Work disability data followed a comparable course.
  
  
  CONCLUSIONS
  Various processes may have contributed to the observed changes. Our hypothesis is corroborated by experimental research showing that BP-related beliefs, attitudes and behaviour could positively be influenced by media campaigns and by insights from another recent epidemic.
authors.affiliation: Institute for Social Medicine, University of Luebeck, D Luebeck, Germany. heiner.raspe@uk-sh.de
authors.forename: Heiner
authors.initials: H
authors.lastname: Raspe
authors.forename: Angelika
authors.initials: A
authors.lastname: Hueppe
authors.forename: Hannelore
authors.initials: H
authors.lastname: Neuhauser
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001416:Back Pain / Q000175:diagnosis* / Q000453:epidemiology*; D015984:Causality; D003141:Communicable Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005859:Germany, East / Q000453:epidemiology; D005860:Germany, West / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution