Author Affiliation: Division of Research, Northern California Kaiser-Permanente, Oakland.
Nonspecific chronic low back pain (LBP) remains one the most prevalent, expensive, and poorly treated conditions seen by primary care clinicians.1 The etiology of most chronic LBP is unknown; therefore, treatment approaches are often empiric and usually based on a relatively thin foundation of evidence. Most interventions have not been rigorously tested and many back pain studies are limited by poor design and research practice, so little is known about what treatments are or are not effective for patients with chronic LBP. Because patient-specific diagnosis and treatment plans cannot be rationally formulated in most cases,2 patients frequently experiment with a variety of interventions, often turning to complementary and alternative therapies.3,4
Avins AL. Glucosamine and the Ongoing Enigma of Chronic Low Back Pain. JAMA. 2010;304(1):93-94. doi:10.1001/jama.2010.922