• Gunnar B. J. Andersson
  • Thomas W. McNeill


Low back pain, with or without sciatica, is one of the most common complaints presenting to a physician. The causes of these complaints are numerous and include pathological changes in several different tissues, structures and organs. To the physician in the past low back pain, as a symptom of systemic disease was more important than back pain originating from pathological changes of the spinal structures per se. Low back pain as an independent issue did not become clinically important until the 1930’s. At that time a combination of changes in the political, social and medical arena gave the complaint of low back pain new importance. Medical interest rose rapidly after Mixter and Barr (1934) “rediscovered” the herniated intervertebral disc and offered the possibility of a surgical “cure” for some varieties of this condition. At the same time there was the rapid political acceptance of worker’s compensation laws in the United States, Canada, and Europe. This new social legislation provided compensation for injuries sustained on the job or as a result of the job. Complaining of low back pain then became more meaningful, and accepted. The next link in the chain of events leading up to the current situation was the acceptance of the concept that the likely cause of most low back pain is an injury, which either caused the painful episode directly or, if pain was preexisting, aggravated it. Considerable effort has been expended in laboratories throughout the world to explain the pathological changes in and the mechanisms of these “injuries”. These efforts have had little effect on the problem of low back pain, however, and in fact the incidence has increased in recent years increasing the cost of low back pain to both industry and to society as a whole (Fig. 1).


Back Pain Vertebral Body Intervertebral Disc Facet Joint Vertebral Column 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag/Wien 1989

Authors and Affiliations

  • Gunnar B. J. Andersson
    • 1
  • Thomas W. McNeill
    • 1
  1. 1.Department of Orthopedic SurgeryRush-Presbyterian-St. Luke’s Medical HospitalChicagoUSA

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