Work incapacity from low back pain: the international quest for redress

Disabling back pain plagues industrialized societies. Generally redress adheres to a Prussian paradigm that those injured at work are more deserving than those who have worked but can no longer do so because of diseases not related to work. Those who never have worked are least entitled. A comparison of the way the Prussian paradigm behaves in different cultures is instructive and daunting; no generalizable solution has emerged. It is time to cast off the Prussian paradigm. It is clinically unsound and, judging from the experience of the past century, ethically flawed.