The etiologies of low back pain in patients with lumbar disk herniation

Background : Low back pain (LBP) is a common complaint in population that lowers the quality of life. The main etiology of LBP is recognized in about 20 % of patients while it is attributed to lumbar disk herniation (LDH) in 80 % of cases and causes some unnecessary lumbar surgeries without realizing the definite cause. Objectives : This study was planned to evaluate the etiologies of LBP in patients who had LDH to clarify whether the disc herniation is the main cause of patients’ pain or other diseases were responsible for this kind of pain. Materials and Methods : In this cross-sectional study, we analyzed the medical profiles of the patients with proven LDH 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 by SPSS 13. Results : In our study, among 1250 patients with proven LDH by MRI, 500 patients (40 %) had chronic LBP and the most common causes of LBP were heavy constant working (40.2 %), osteoporosis (35.6 %), and sacroiliac joint pain (34.6 %), consecutively. Interestingly, LDH had the ninth rank among the common cause of LBP. Conclusions : In this study, we found that in spite of previous beliefs, discopathies were not common etiologies of LBP. Thus, even in patients with proven LDH by imaging studies, the physician should perform a thorough evaluation for other causes of LBP to avoid unnecessary lumbar surgeries.