Psychological Distress and Back Pain

Chronic low back pain has become a major health problem in today\u27s society. Low back pain disability is the most expensive benign condition in industrialized countries and is the number one cause of disability in people less than 45 years old (1). Low back pain lasting for longer than one day affects 40 percent of adults in any one-year period (2). In addition, there still is a lot uncertainty as to how structural or morphologic changes in the lumbar spine relate to a patient\u27s clinical symptoms as seen on special imaging studies (3). Further investigations have showed this relationship to be true. In one study by Boden, 67 asymptomatic individuals had a magnetic resonance image (MRI) performed and found at least one herniated disc in 20 percent of the volunteers who were less than 60 years old (4). In this same group of volunteers, they found at least one herniated disc in 36 percent of those individuals who were greater than 60 years old. In another study by Jensen (5), a similar pattern was found in 98 asymptomatic individuals. Just as there is uncertainty in diagnosis of low back pain, there also is uncertainty in choosing the best form of treatment for the long-term relief of low back pain