Epidemiology, etiology, diagnostic evaluation, and therapy of low back pain

New data concerning the epidemiology, etiology, diagnostic evaluation, and treatment of low back pain have been reported over the past year. Patients who have a longer period of pain during the initial episode of pain are at greatest risk of recurrence of pain. Abnormalities of fibrinolytic activity may have predictive value in identifying patients who are at risk for a poor outcome from surgery. Scheuermann's kyphosis is a slowly progressive illness that rarely requires surgical stabilization of the spine. Contrast-enhanced magnetic resonance imaging may be able to identify symptomatic spinal nerve roots. Radiculopathy associated with disk herniations resolves frequently without surgical intervention. Large disk herniations may resolve spontaneously and do not require surgery. Spinal manipulation may be helpful on a short-term basis to decrease back pain but may be associated with occasional serious complications including cauda equina compression.