[Lower back pain: understanding it is more important than treating it]

Nonspecific lower back pain is frequently encountered in primary care, with 25-50% of cases following a chronic course. Over recent decades, a large body of research has focused on the effectiveness of both pharmacological and non-pharmacological treatments. However, hardly any effective interventions have been identified and the overall strength of evidence is low. We argue that the reason for these disappointing results lies in the 'nonspecific' nature of back pain. It is widely recognised that the causes for nonspecific back pain are not only biologically, but also psychologically and socially determined. Future research should emphasise aetiology and prognosis in order to enhance the development of tailored interventions.