TheAnswerPage/Pain Management Monday 03/15/2010 This week: Acute back pain

We are starting a module on acute low back pain.  Back pain is one of the most common complaints patients have for going to their physician, and as such is a major issue for us.  We will have a section later in the year dedicated to chronic low back pain.   

Question:

An executive from a large, local company comes to you for consultation regarding their employees continuing absences due to back trouble.  They are spending a large amount of money in physician fees as well as losing money due to lack of productivity and disability related expenses.  She would like to know how large a problem back trouble is in America and compare it to their experience.

1. How common is back trouble and how often does it come to a doctor's attention?
2. How would you differentiate between acute and chronic back "problems"?  What proportion of back problems is chronic and what percentage of a corporation's expenses can be expected to be devoted to the chronic vs. acute patient?
3. Are there signals to predict whether patients with acute back pain will go on to have chronic back pain?
4. What is the natural history of acute back pain?

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