Anamnestische und klinische Befunde bei schweren Rückenschmerzen: eine klinisch epidemiologische Untersuchung an einer Stichprobe von LVA-Versicherten

Abstract

Idiopathic (unspecific) low back pain is the most common rheumatological complaint. Results of international studies give evidence that in about 80 % of the cases a specific diagnosis is not possible, thus creating an unsatisfactory situation for the orthopaedist. We feel that it is necessary to keep the discussion on the rate of specific causes for low back pain open. In the context of a research project on the need for rehabilitation, 335 subjects suffering from severe low back pain were subjected to a physical (orthopaedic-neurological) examination. Also, a questionnaire was distributed assessing psychological status, work situation, comorbid conditions, risk factors, and demography. In more than half of the subjects, clues for a specific cause for the back pain were found; in more than one third of the cases there were one or more neurological signs. The data presented demonstrate that specific causes for low back pain might be more common than generally assumed. This leads us to the conclusion that there is a need for more clinically-oriented, population-based (epidemiological) research on possible pathologic causes of low back pain and comorbid conditions.