title: What is the source of low back pain?
abstract: OBJECTIVE
  Determining the source of low back pain (LBP) is still controversial. This study was designed to determine the source of LBP and its relations with age and gender.
  
  
  METHODS
  A retrospective chart review at Isfahan University of Medical Sciences, Isfahan, Iran.
  
  
  METHODS
  A total of 1,125 patients were evaluated to determine the sources of their LBP with physical examinations, imaging, injections, and other laboratory examinations, if needed. The patients were divided into five groups based on their ages. Frequencies of the sources of pain were assessed in the five age groups, and the assessments were done separately by gender.
  
  
  METHODS
  Independent t-test, analysis of variance (ANOVA), chi-square test.
  
  
  RESULTS
  The patients enrolled in this study consisted of 527 males (46.8%) and 598 females (53.2%). The frequencies of the sources of pain were, in descending order, spine (689, 61.2%), no cause found (163, 14.5%), spine with sacroiliac joint (SIJ) (72, 6.4%), spine with hip (65, 5.8%), SIJ (60, 5.3%), hip (44, 3.9%), spine along with hip and SIJ (20, 1.8%), hip with SIJ (8, 0.7%), and other diseases (4, 0.4%). There were significant statistical differences between the genders and mean ages for different sources (P = 0.03 and 0.000, respectively).
  
  
  CONCLUSIONS
  This study showed that the spine was the main source of LBP in all age groups. Physicians should always be alert for other sources in middle-aged and older patients. Future studies with long-term follow-up for determining the benefits of treatments are warranted.
authors.affiliation: Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Shemshaki
authors.affiliation: Medical Student Research Committee, Department of Biological Sciences, California State University, Stanislaus, Turlock, United States.
authors.forename: Sayed-Mohammad Amin
authors.initials: SM
authors.lastname: Nourian
authors.affiliation: Persia Research Center, Sadi Hospital, Isfahan, Iran.
authors.forename: Mahboobeh
authors.initials: M
authors.lastname: Fereidan-Esfahani
authors.affiliation: Medical Student Research Committee, Research Assistant, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Mokhtari
authors.affiliation: Department of Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Etemadifar
keywords: Etiology; low back pain; source; spine