• The most frequent diagnosis in 3,587 cases of pain low in the back was lumbosacral strain. This accounted for 1,603 cases, of which 1,108 were associated with congenital anomalies while 495 were unexplained by roentgenoscopy.
In many of these patients the symptoms had existed for more than three years. Conservative treatment included the full resources of physical medicine, but surgery frequently became necessary. Lumbosacral fusion was carried out in 152 patients, and in 25 of these the fascia lata was also divided.
A protruded intervertebral disk was found in 83 cases; it was excised in 28 patients, and 19 became symptom-free. Sacroiliac strain or sprain was diagnosed in only 271 instances, and practically all of these diagnoses were made early in the 25-year period covered by this survey.
Diveley RL, Kiene RH, Meyer PW. LOW BACK PAIN. JAMA. 1956;160(9):729-731. doi:10.1001/jama.1956.02960440001001