Die aktuelle Rückenschmerzepidemie.

All available data presented show that we are confronted with a back-pain (BP) epidemic; it affects numerous industrialized countries. More severe forms of BP make up one fifth of the prevalence. The greater part of BP seems to be mild, especially among persons aged 25 to 54. The social insurance statistics, too, show an alarming trend. Cases of work incapacity and medical rehabilitation have increased drastically: one sixth of all cases of work incapacity as well as one third of all medical rehabilitations are to be accounted to BP. It is not easy to interpret the data. Do they represent an increasing BP epidemic? A long-term secular trend towards higher BP prevalences at the population level is to be assumed but cannot be proven at the moment. Is there any evidence that BP-related risk factors have increased? To our knowledge there are no reliable data. It is also to be considered that the 'natural' course of BP may have changed. Is the epidemic a consequence of an increasing 'chronification' of BP due to physical, psychosocial or medical influences? Do 'back-schools' and other factors regarding the BP business have only health-promoting effects? Does the date represent a changing perception and appraisal of pain and/or a changing 'pain-reporting behaviour'? Is 'pain' today what would have been 'discomfort' in former times? Does one complain about BP today when one would have been silent in former times? There are no valid data for these hypotheses, either. Finally, has the transition probability from pain to disability and to social benefits changed?(ABSTRACT TRUNCATED AT 250 WORDS)