[Chronic back pain and expert opinion]

Back pain, especially chronic back pain, is not only a medical and psychological burden but also an economic problem due to the extremely high associated costs. These are generated by treatment and rehabilitation measures, pensions and loss of working hours. The cause of pain is multifocal and frequently remains unclear. It is not the etiology of back pain that has changed in the last 20 years, but its rate of assessment and treatment options. According to the relevant literature, treatment of chronic back pain will most probably only succeed using multimodal concepts that have to consider medical/somatic and psychosocial aspects and be based on scientific training experience. Pain assessment is based on common legal and certification standards. However, typical decision and rating problems result from the difficulty of objective medical registration and grading of pain. Medical certification may often be complicated by co-morbidities such as somatic pain attacks, fibromyalgia, depression or anxiety. These cases necessitate close cooperation with other medical specialities.