Chronic low back pain
Seminowicz, David A. Department of Neural Pain Sciences, Pain Imaging Lab, and School of Dentistry, Baltimore, Maryland.
Last reviewed:January 2019
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- Peripheral mechanisms
- Central nervous system mechanisms
- Physical and psychological components of CLBP
- Future directions
- Links to Primary Literature
- Additional Readings
Any persistent pain occurring in the lumbar (lower) back, sometimes extending to the buttocks and legs, which has been present for at least 3 months. Chronic low back pain (CLBP) [Fig. 1] is usually a combination of musculoskeletal and neuropathic pain, or pain that occurs as a result of damage to the nervous system. Neuropathic pain is typically indicated by the presence of radiating pain down the leg, pain of a shooting or electrical quality, and increased sensitivity to cold. The majority of CLBP cases are referred to as nonspecific, that is, they occur in the absence of an obvious organic cause, whereas mechanical problems (including disc, spinal, and muscular problems, as well as other deformations) account for the next greatest percentage of cases. Relatively few cases of CLBP result from cancer, infection, inflammation, or referred pain from visceral diseases. Because most CLBP is nonspecific, the disorders are categorized as a functional pain syndrome, which includes other pain conditions (for example, migraine, fibromyalgia, and chronic pelvic pain). Acute low back pain affects more than 80% of the population at some point in their lifetime, whereas CLBP occurs in more than 20% of adults who are 20 to 59 years old. It is more prevalent in women than men, and its prevalence increases in individuals from 30 to 60 years of age. CLBP is considered one of the most burdensome medical conditions worldwide, with enormous societal effects via the cost of treating the condition. See also: Molecular components of itch, pain, and touch sensation; Muscular system; Muscular system disorders; Pain; Skeletal system; Spinal cord; Spinal cord disorders; Vertebra
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