The Etiologies of Low Back Pain in Patients with Lumbar Disk Herniation

Abstract

Background: Low back pain (LBP) is a common complaints in population which lower the quality of life. The main etiology of LBP is recognized just in about 20 % of patients, while in 80% of cases it has been attributed to lumbar disk herniation and causes some unnecessary lumbar surgeries without realizing the certain cause. Consequently, this study was planned to evaluate the etiologies of LBP in patients who had lumbar disc herniation to clarify whether the disc herniation is the main cause of patients` pain or other diseases rather than disc herniation are responsible for this kind of pain.

Materials and Methods: In this cross sectional study, we analyzed the medical profiles of the patients with proven lumbar disc herniation in a private clinic in Mashhad City, Iran between 2005 and 2012 for demographic and the etiologies of LBP with clinical and paraclinical studies. We also calculated the incidence of each etiology in aid of SPSS software (version 13).

Results: In our study, among 1250 patients with proven lumbar disc herniation by MRI, 500(40%) patients had chronic LBP, and the most common causes of LBP were heavy constant working (40.2%), Osteoporosis (35.6%) and Sacro-iliac joint pain (34.6%) respectively, and interestingly the lumbar disc herniation as the cause of their LBP was in 9th rate.

Conclusion: In this study we found that in spite of previous beliefs, discogenic etiologies are not common causes of LBP. Thus, even in patients with proven lumbar disc herniation by imaging, the physician should perform a thorough evaluation of the patient for other causes of LBP rather than lumbar disc herniation for avoiding unnecessary lumbar surgery.