Abstract
Every year one in five adults will have low back pain.1 Even in silent sufferers (ie, those not seeking treatment), the back is the second most frequent location of pain.2 Acute episodes, lasting less than 3 months (90% of cases), are usually benign and do not need specific treatment. Indeed, overtreatment is often the major danger for these patients. However, the 5–15% of acute cases with an established cause do need to be identified at the first consultation and treated accordingly. Chronic low back pain, lasting more than 3 months, accounts for no more than 10% of cases but is one of the greatest health problems in industrialised societies, with costs of US$100–$200 billion a year.
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