Scientific Retreats 2010

Monday, March 22, 2010 (historical)

Session Topic: Chronic Low Back Pain


Approximately 80% of Americans experience low back pain during their lifetime (1). An estimated 15-20% develop protracted pain, and approximately 2-8% have chronic pain (1). Chronic low back pain is defined as pain that persists for more than 3 months. Every year, 3-4% of the population is temporarily disabled, and 1% of the working-age population is disabled permanently. In the U.S., low back pain is second only to the common cold as a cause of lost work time; it is the fifth most frequent cause for hospitalization, and the third most common reason to undergo a surgical procedure (1). Additionally, Americans spend at least $50 billion each year on low back pain (2,3).

The 2-8% of Americans with chronic low back pain is particularly significant (1). It is often progressive, and the cause can be difficult to determine. More importantly, previous studies have shown that patients with chronic low back pain consume at least 75% of our total expenditures for treating low back pain (3).

Goals of the Session

This session will discuss the current state-of-the-science in chronic low back pain, including epidemiology, causal factors, cost, and current treatments, with the goal of identifying opportunities for future NIAMS-funded research and collaborative activities.

Key Questions

  • What are the roles of epidemiological studies of the causes of chronic low back pain, especially in elderly populations, where the numbers, complexity, and costs of treatment for these disorders have markedly increased?
  • What is the relationship(s) between the factors associated with the transition from acute to chronic low back pain (i.e., physiological, socioeconomic, work-related factors, and patient expectations)? What are the barriers or obstacles preventing a better understanding of the transition from acute to chronic low back pain?
  • What role does the current clinical management of acute low back pain play in the development of chronic low back pain (i.e., imaging studies, pain management, and other treatment influences)?
  • What intervention and prevention studies need to be done that could provide the quality and strength of evidence that could be used to better inform health care providers and individuals experiencing chronic low back pain?

Expected Outcomes

This session will identify research needs and opportunities in the area of chronic low back pain. It will help the NIAMS assess the Institute’s role in advancing research in chronic low back pain, as well as help to evaluate the need for collaborative activities.


  1. Andersson, Gunnar BJ, Epidemiological Features of Chronic Back Pain, Lancet, 354, pages 581-585, 1999.
  2. Hazard, Rowland G., Low-Back and Neck Pain Diagnosis and Treatment, AM J Phys Med Rehabil, Vol 86, No. 1, Supplement, , pages 59-68, January 2007.
  3. Katz, Jeffrey N. Lumbar Disc Disorders and Low-Back Pain: Socioeconomic factors and Consequences, The Journal of Bone and Joint Surgery, Volume 88-A, Supplement 2, Supplement 2, pages 21-24, 2007.

Additional References

Manek, NJ, et al, Epidemiology of back disorders: prevalence, risk factors, and prognosis, Current opinion in rheumatology, 17, 2005, pages 134-140.

Martin, BI, et al, Trends in Health Care Expenditures, Utilization, and Health Status Among US Adults With Spine Problems, 1997–2006, Spine, Volume 34, Number 19, 2009, pages 2077-2084.

Chou, Roger, et al, A Review of the Evidence for an American Pain Society Clinical Practice Guideline, Spine, volume 34, Number 10, 2009, pages 1094-1109.