The Lumbar Spine: Mechanical Diagnosis and Therapy 2nd by Robin A. McKenzie, Stephen May

By Robin A. McKenzie, Stephen May

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1995b, 2000). Many people with low back pain cope independently in the community and do not seek help, w hether medical or alternative. 6 OF BAC K PA I N C H A PTE R O N E Proportion of back pain population who seek health care % who % who % who consult consult physiochirop'ractor therap'ist % who Relerence consult Country GP consult osteopath Dodd 1997 UK 38% 6% 3% 9% Walsh eL al. 1992 UK 40% al. 5% 1% 10% 5% Hillman eL Limon eL Carey eL al. 1998 al. 1996 McKinnon eL 1997 al. SanLos-Eggimann al.

Individual risk factors The strongest rish factor for future bach pain is histolY oj past bach pain. tal predictive role in future episodes (Frank et al. 1996; Ferguson and Marras 1997). Frank et al. dual with a previous history is three to four times more l ikely to develop back pain than someone without that history. The epidemiology reviewed in Chapter 1 suggests that more than half of those who have an episode of back pain will have a recurrence. The association of increasing age and female gender to back pain are less well established.

1993; Waters et al. 1999; Zwerling et al. 1993) repeated bending at home (Mundt et eL al. 1993) prolonged bending (Punnell et al. 1991; Hoogendoom eL al. 2000a) • unexpected spinal loading (Mag01'a 1973) • driving (Kelsey 1975; Kelsey et al. 1984b; Frymoyer et al. 1983; Damkot et al. 1984; Krause et al. 1997; Masset and Malchaire 1994) sedentary jobs (Kelsey 1975) a high incidence of back pain has been found in those who spend a lot of their working day either sitting or standing, but was much less common in those who were able to vary their working positions regularly during the day (Magora 1972).

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