腰痛是一种具有社会经济学重要性的常见的临床病症。 约70%-85%的成年人在一生中的某个时间会经历腰痛。[4]Andersson GB. Epidemiological features of chronic low back pain. Lancet. 1999 Aug 14;354(9178):581-5.http://www.ncbi.nlm.nih.gov/pubmed/10470716?tool=bestpractice.com[5]Carragee EJ, Hannibal M. Diagnostic evaluation of back pain. Orthop Clin North Am. 2004 Jan;35(1):7-16.http://www.ncbi.nlm.nih.gov/pubmed/15062713?tool=bestpractice.com 每年,腰痛影响着约三分之一的英国成年人;然而,仅有约20%的腰痛者向医生咨询。[6]National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. November 2016 [internet publication].https://www.nice.org.uk/guidance/NG59
尽管一些不同的脊柱解剖结构(关节突关节,椎间盘,椎体及肌肉),以及其他腹腔内或胸腔下部病变,也是可能导致腰痛的原因,但最常见的原因仍是退行性变的腰椎间盘。[7]Deyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001 Feb 1;344(5):363-70.http://www.ncbi.nlm.nih.gov/pubmed/11172169?tool=bestpractice.com[8]Mooney V. Where is the lumbar pain coming from? Ann Med. 1989 Oct;21(5):373-9.http://www.ncbi.nlm.nih.gov/pubmed/2532527?tool=bestpractice.com[9]Nachemson AL. The lumbar spine an orthopedic challenge. Spine. 1976;1:59-71.[10]Kuslich SD, Ulstrom CL, Michael CJ. The tissue origin of low back pain and sciatica: a report of pain response to tissue stimulation during operations in lumbar spine using local anaesthesia. Orthop Clin North Am. 1991 Apr;22(2):181-7.http://www.ncbi.nlm.nih.gov/pubmed/1826546?tool=bestpractice.com[11]Schwarzer AC, Aprill CN, Derby R, et al. The relative contributions of the disc and zygapophyseal joint in chronic low back pain. Spine (Phila Pa 1976). 1994 Apr 1;19(7):801-6.http://www.ncbi.nlm.nih.gov/pubmed/8202798?tool=bestpractice.com
椎间盘退变的放射学证据在三十多岁的人即可找到。 发病率及严重性的变化随时间以每年3%-4%递增。[12]Hassett G, Hart DJ, Manek NJ, et al. Risk factors for progression of lumbar spine disc degeneration: the Chingford study. Arthritis Rheum. 2003 Nov;48(11):3112-7.http://onlinelibrary.wiley.com/doi/10.1002/art.11321/fullhttp://www.ncbi.nlm.nih.gov/pubmed/14613273?tool=bestpractice.com[13]Hangai M, Kaneoka K, Kuno S, et al. Factors associated with lumbar intervertebral disc degeneration in the elderly. Spine J. 2008 Sep-Oct;8(5):732-40.http://www.ncbi.nlm.nih.gov/pubmed/18037353?tool=bestpractice.com 然而,症状与影像学发现之间没有明确的相关性。