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Disorders of the Back and Neck

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Family Medicine

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Abstract

Low back pain occurs in 60% to 80% of adults at some point in their lives and is second only to upper respiratory infections as a cause for absence from work.1 Each year 2% of all American workers have a compensable back injury, and 14% lose at least one work day due to low back pain.2 Among chronic conditions, back problems are the most frequent cause for limitation of activity (work, housekeeping, school) among patients under 45 years of age.3 Nonsurgical low back pain is the fourth most common admission diagnosis for patients over 65.4 Although low back pain is usually a self-limited problem, it still costs approximately $24 billion per year in direct medical expenses and another $27 billion per year in lost productivity and compensation.5 In most cases, low back pain is treated successfully with a conservative regimen, supplemented by selective use of neuroradiologic imaging and appropriate surgical intervention for a few patients.6

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References

  1. Spitzer WO, LeBlanc FE, Dupuis M, et al. Scientific approach to the assessment and management of activity related spinal disorders: a monograph for clinicians: report of the Quebec Task Force on Spinal Disorders. Spine 1987;12 Suppl 1:S1–59.

    Article  Google Scholar 

  2. Loeser JD, Volinn E. Epidemiology of low back pain. Neu-rosurg Clin North Am 19912:713.

    Google Scholar 

  3. Deyo RA. Conservative therapy for low back pain. JAMA 1983;250:1057–62.

    Article  PubMed  CAS  Google Scholar 

  4. Deyo RA, Loeser JD, Bigos SJ. Herniated lumbar inter-vertebral disc. Ann Intern Med 1990;112:598–603.

    Article  PubMed  CAS  Google Scholar 

  5. Frymoyer JW, Cats-Baril WL. An overview of the incidences and costs of low back pain. Orthop Clin North Am 1991; 22:263–71.

    PubMed  CAS  Google Scholar 

  6. Frymoyer JW. Back pain and sciatica. N Engl J Med 1988; 318:291–300.

    Article  PubMed  CAS  Google Scholar 

  7. Frymoyer JW, Pope MH, Clements JH, Wilder DG, MacPherson B, Ashikaga T. Risk factors in low back pain: an epidemiological survey. J Bone Joint Surg [Am] 1983;65:213–18.

    CAS  Google Scholar 

  8. Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low back pain and its related medical care in the United States. Spine 1987;12:264–8.

    Article  PubMed  CAS  Google Scholar 

  9. Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA 1992;268:760–5.

    Article  PubMed  CAS  Google Scholar 

  10. Hazard RG, Fenwick JW, et al. Functional restoration with behavioral support: a one-year prospective study of patients with chronic low back pain. Spine 1989;14:157–69.

    Article  PubMed  CAS  Google Scholar 

  11. Weber H. Lumbar disc herniation: a controlled prospective study with ten years of observation. Spine 1983;8:131–40.

    Article  PubMed  CAS  Google Scholar 

  12. National Center for Health Statistics. Prevalence of selected impairments. U.S., 1977. Series 10, No. 132. Hyattsville, MD: DHHS, 1981. Publ. (PHS) 81–1562.

    Google Scholar 

  13. Frymoyer JW, Nachemson A. Natural history of low back disorders. In: Frymoyer JW, editor. The adult spine: principles and practice. New York: Raven, 1991:1537–50.

    Google Scholar 

  14. Wipf JE, Deyo RA. Low back pain. Med Clin North Am 1995;79:231–46.

    PubMed  CAS  Google Scholar 

  15. Mixter WJ, Barr JS. Rupture of inter-vertebral disc with involvement of the spinal canal. N Engl J Med 1934;211:210–15.

    Article  Google Scholar 

  16. Nachemson A. Newest knowledge of low back pain: a critical look. Clin Orthop 1992;279:8–20.

    PubMed  Google Scholar 

  17. Deyo RA, Bass JE. Lifestyle and low back pain: the influence of smoking and obesity. Spine 1989;14:501–6.

    Article  PubMed  CAS  Google Scholar 

  18. Fairbank JCT, Hall H. History taking and physical examination: identification of syndromes of back pain. In: Weinstein JN, Wiesel SW, editors. The lumbar spine. Philadelphia: Saunders, 1990:88–106.

    Google Scholar 

  19. Modic MT, Ross JS. Magnetic resonance imaging in the evaluation of low back pain. Orthop Clin North Am 1991;22: 283–301.

    PubMed  CAS  Google Scholar 

  20. Deyo RA, Diehl AK. Lumbar spine films in primary care: current use and effects of selective ordering criteria. J Gen Intern Med 1986;1:20–5.

    Article  PubMed  CAS  Google Scholar 

  21. Hensinger RN. Spondylolysis and spondylolisthesis in children and adolescents. J Bone Joint Surg [Am] 1989;71:1098–1107.

    CAS  Google Scholar 

  22. Frymoyer JW, Newberg A, Pope MH, Wilder DG, Clements J, MacPherson B. Spine radiographs in patients with low back pain: an epidemiological study in men. J Bone Joint Surg [Am] 1984;66:1048–55.

    CAS  Google Scholar 

  23. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging in people without back pain. N Engl J Med 1994;331:69–73.

    Article  PubMed  CAS  Google Scholar 

  24. Modic MT, Masaryk T, Boumphrey F, Goormastic M, Bell G. Lumbar herniated disc disease and canal stenosis: prospective evaluation by surface coil MR, CT, and myelography. AJR 1986;147:757–65.

    Article  PubMed  CAS  Google Scholar 

  25. McCowin PR, Borenstein D, Wiesel SW The current approach to the medical diagnosis of low back pain. Orthop Clin North Am 1991;22:315–25.

    PubMed  CAS  Google Scholar 

  26. Barth RW, Lane JM. Osteoporosis. Orthop Clin North Am 1988;19:845–58.

    PubMed  CAS  Google Scholar 

  27. Deyo RA, Diehl AK. Cancer as a cause of back pain: frequency, clinical presentation, and diagnostic strategies. J Gen Intern Med 1988;3:230–8.

    Article  PubMed  CAS  Google Scholar 

  28. Bates DW, Reuler JB. Back pain and epidural spinal cord compression. J Gen Intern Med 1988;3:191–7.

    Article  PubMed  CAS  Google Scholar 

  29. Perrin RG. Symptomatic spinal metastases. Am Fam Physician 1989;39:165–72.

    PubMed  CAS  Google Scholar 

  30. Jackson RP. The facet syndrome: myth or reality? Spine 1992; 279:110–21.

    Google Scholar 

  31. Carette S, Marcoux S, Truchon R, et al. A controlled trial of corticosteroid injections into facet joints for chronic low back pain. N Engl J Med 1991;325:1002–7.

    Article  PubMed  CAS  Google Scholar 

  32. Lilius G, Laasonen EM, Myllynen P, Harilainen A, Gronlund G. Lumbar facet joint syndrome: a randomized clinical trial. J Bone Joint Surg [Br] 1989;71:681–4.

    CAS  Google Scholar 

  33. Frymoyer JW, Rosen JC, Clements J, Pope MH. Psychologic factors in low back pain disability. Clin Orthop 1985;195: 178–84.

    PubMed  Google Scholar 

  34. Wheeler AH. Diagnosis and management of low back pain and sciatica. Am Fam Physician 1995;52:1333–41.

    PubMed  CAS  Google Scholar 

  35. Deyo RA, Diehl AK, Rosenthal M. How many days of bedrest for acute low back pain? A randomized clinical trial. N Engl J Med 1986;315:1064–70.

    Article  PubMed  CAS  Google Scholar 

  36. Deyo RA, Walsh NE, Martin DC, Schoenfeld LS, Ramamurthy S. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med 1990;322:1627–34.

    Article  PubMed  CAS  Google Scholar 

  37. Kendall PH, Jenkins JM. Exercises for backache: a double blind controlled trial. Physiotherapy 1968;54:154–9.

    Google Scholar 

  38. Williams PC. Lesions of lumbo-sacral spine. Part 2. J Bone Joint Surg 1937;19:690–703.

    Google Scholar 

  39. McKenzie RA. Prophylaxis in recurrent low back pain. N Z Med J 1979;89:22–3.

    PubMed  CAS  Google Scholar 

  40. Elnaggar IM, Nordin M, Sheikhzadeh A, Parnianpour M, Kahanovitz N. Effects of spinal flexion and extension exercises on low back pain and spinal mobility in chronic mechanical low-back pain patients. Spine 1991;16:967–72.

    Article  PubMed  CAS  Google Scholar 

  41. Jackson CP, Brown MD. Analysis of current approaches a practical guide to prescription of exercise. Clin Orthop 1983; 179:46–54.

    PubMed  Google Scholar 

  42. Cady LD, Bischoff DP. Strength and fitness and subsequent back injuries in firefighters. J Occup Med 1979;21:269–73.

    Article  PubMed  CAS  Google Scholar 

  43. Berquist-Ullman M, Larsson U. Acute low back pain in industry: a controlled prospective study with special reference to therapy and confounding factors. Acta Orthop Scand Suppl 1977;170:1–117.

    Google Scholar 

  44. Hall H, Iceton JA. Back school: an overview with specific reference to the Canadian back education units. Clin Orthop 1983;179:10–17.

    PubMed  Google Scholar 

  45. Stankovic R, Johnell O. Conservative treatment of acute low back pain. Spine 1990;15:120–3.

    Article  PubMed  CAS  Google Scholar 

  46. Cohen JE, Goel V, Frank JW, Bombardier C, Peloso P, Guillemin F. Group education interventions for people with low back pain. Spine 1994;19:1214–22.

    Article  PubMed  CAS  Google Scholar 

  47. Klaber-Moffett JA, Chase SM, Portek I, Ennis JR. A controlled prospective study to evaluate the effectiveness of a back school in the relief of chronic low back pain. Spine 1986;11:120–2.

    Article  PubMed  CAS  Google Scholar 

  48. Cherkin DC, Deyo RA, Loeser JD, Bush T, Waddell G. An international comparison of back surgery rates. Spine 1994; 19:1201–6.

    Article  PubMed  CAS  Google Scholar 

  49. Taylor VM, Deyo RA, Cherkin DC, Kreuter W. Low back pain hospitalization: recent U.S. trends and regional variations. Spine 1994;19:1207–13.

    Article  PubMed  CAS  Google Scholar 

  50. Hurme M, Alaranta H. Factors predicting the results of surgery for lumbar inter-vertebral disc herniation. Spine 1987; 12:933–8.

    Article  PubMed  CAS  Google Scholar 

  51. Abramovitz JN, Neff SR. Lumbar disc surgery: results of the prospective lumbar discectomy study. Neurosurgery 1991 ;29: 301–48.

    Google Scholar 

  52. Van Alphen HAM, Braakman R, Bezemer PD, Broere G, Berfelo MW. Chemonucleolysis vs. discectomy: a randomized multicenter trial. J Neurosurg 1989;70:869–75.

    Article  PubMed  Google Scholar 

  53. Hoffman RM, Wheeler KJ, Deyo RA. Surgery for herniated lumbar discs: a literature synthesis. J Gen Intern Med 1993; 8:487–96.

    Article  PubMed  CAS  Google Scholar 

  54. Revel M, Payan C, Vallée C, et al. Automated percutaneous lumbar discectomy vs. chemonucleolysis in the treatment of sciatica. Spine 1993;18:1–7.

    Article  PubMed  CAS  Google Scholar 

  55. Nordby EJ, Wright PH. Efficacy of chymopapain in chemonucleolysis: a review. Spine 1994;19:2578–83.

    Article  PubMed  CAS  Google Scholar 

  56. Deyo RA, Cherkin DC, Loeser JD, Bigos SJ, Ciol MA. Morbidity and mortality in association with operations on the lumbar spine: the influence of age, diagnosis, and procedure. J Bone Joint Surg [Am] 1992;74:536–43.

    CAS  Google Scholar 

  57. Mayer TG, Gatchel RJ, Mayer H, Kishino ND, Keeley J, Mooney V. A prospective 2-year study on functional restoration in industrial low back injury: an objective assessment procedure. JAMA 1987;258:1763–7.

    Article  PubMed  CAS  Google Scholar 

  58. Turner JA, Denny MC. Do antidepressant medications relieve chronic low back pain? J Fam Pract 1993;37:545–53.

    PubMed  CAS  Google Scholar 

  59. Lahad A, Malter AD, Berg AO, Deyo RA. The effectiveness of four interventions for the prevention of low back pain. JAMA 1994;272:1286–91.

    Article  PubMed  CAS  Google Scholar 

  60. Kelsey JL, Githens PB, Walter SD, et al. An epidemiological study of acute prolapsed cervical intervertebral disc. J Bone Joint Surg [Am] 1984;66:907–14.

    CAS  Google Scholar 

  61. Clark CR. Degenerative conditions of the spine. In: Frymoyer JW, editor. The adult spine: principles and practice. New York: Raven, 1991:1145–64.

    Google Scholar 

  62. Lestini WF, Wiesel SW. The pathogenesis of cervical spondylosis. Clin Orthop 1989;239:69–93.

    PubMed  Google Scholar 

  63. Jahnke RW, Hart BL. Cervical stenosis, spondylosis, and herniated disc disease. Radiol Clin North Am 1991;29:777–91.

    PubMed  CAS  Google Scholar 

  64. Russell EJ. Cervical disk disease. Radiology 1990;177:313–25.

    PubMed  CAS  Google Scholar 

  65. Dillin W, Booth R, Cuckler J, Balderston R, Simeone F, Rothman R. Cervical radiculopathy: a review. Spine 1986;11:988–91.

    Article  PubMed  CAS  Google Scholar 

  66. Murphy MJ, Lieponis JV. Non-operative treatment of cervical spine pain. In: Sherk HH, editor. The cervical spine. Philadelphia: Lippincott, 1989:670–7.

    Google Scholar 

  67. La Rocca H. Cervical spondylotic myelopathy: natural history. Spine 1988;13:854–5.

    Article  Google Scholar 

  68. White AA III, Panjabi MM. Biomechanical considerations in the surgical management of cervical spondylotic myelopathy. Spine 1988;13:856–69.

    Article  PubMed  Google Scholar 

  69. Hirsch SA, Hirsch PJ, Hiramoto H, Weiss A. Whiplash syndrome: fact or fiction? Orthop Clin North Am 1988;19:791–5.

    PubMed  CAS  Google Scholar 

  70. North American Spine Society’s Ad Hoc Committee on Diagnostic and Therapeutic Procedures. Common diagnostic and therapeutic procedures of the lumbosacral spine. Spine 1991;16:1161–7.

    Article  Google Scholar 

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Authors
  1. Walter L. Calmbach
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Editor information

Editors and Affiliations

  1. Department of Family Medicine, Oregon Health Sciences University, Portland, OR, 97201, USA

    Robert B. Taylor M.D. (Professor and Chairman) (Professor and Chairman)

  2. Department of Family Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA

    Alan K. David M.D. (The Fred Lazarus, Jr., Professor and Director) (The Fred Lazarus, Jr., Professor and Director)

  3. Department of Family Medicine, St. John’s Mercy Medical Center, St. Louis, MO, 63141, USA

    Thomas A. Johnson Jr. M.D. (Chairman) (Chairman)

  4. Department of Family Medicine, University of Mississippi School of Medicine, Jackson, MS, 39216, USA

    D. Melessa Phillips M.D. (Professor and Chairman) (Professor and Chairman)

  5. Department of Family Medicine, University of California—Irvine College of Medicine, Orange, CA, 92697, USA

    Joseph E. Scherger M.D., M.P.H. (Associate Dean for Primary Care and Chair) (Associate Dean for Primary Care and Chair)

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© 1998 Springer Science+Business Media New York

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Calmbach, W.L. (1998). Disorders of the Back and Neck. In: Taylor, R.B., David, A.K., Johnson, T.A., Phillips, D.M., Scherger, J.E. (eds) Family Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2947-4_109

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  • DOI: https://doi.org/10.1007/978-1-4757-2947-4_109

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-2949-8

  • Online ISBN: 978-1-4757-2947-4

  • eBook Packages: Springer Book Archive

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