Coste J, Paolaggi J B
Service de Rhumatologie, Hôpital Ambroise Paré, Boulogne.
Rev Epidemiol Sante Publique. 1989;37(4):371-83.
High frequency occurrence of back pain and the magnitude of its impact on society explain the large number of epidemiologic studies. Most investigators have considered back pain as a whole, without reference to different etiological types of back pain, probably for lack of an available classification of these types. Prevalence of back pain in general populations varies between 14 and 45% and annual incidence around 6%. Risk factors for low back pain are often social or cultural factors: smoking, driving, psychological stress. These factors seem to be far from the starting point of the disease process. Vagueness of case descriptions may explain in part the disappointing results of analytic surveys. Indistinctness of risk factors, especially workplace factors, is the principal reason for the poor results of intervention epidemiology: very few primary prevention programs and no educational programs ("low back school") have been shown to be really effective.
背痛的高发性及其对社会的影响程度解释了大量的流行病学研究。大多数研究者将背痛视为一个整体，而没有参考背痛的不同病因类型，这可能是因为缺乏这些类型的可用分类。一般人群中背痛的患病率在14%至45%之间，年发病率约为6%。腰痛的风险因素通常是社会或文化因素：吸烟、开车、心理压力。这些因素似乎与疾病过程的起始点相距甚远。病例描述的模糊性可能部分解释了分析性调查令人失望的结果。风险因素的不明确，尤其是工作场所因素，是干预流行病学效果不佳的主要原因：很少有一级预防项目和教育项目（“腰痛学校”）被证明真正有效。
