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Controversies in Internal Medicine
July 8, 2002

Lack of Evidence-Based Research for Idiopathic Low Back Pain: The Importance of a Specific Diagnosis

Author Affiliations

Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002

Arch Intern Med. 2002;162(13):1442-1444. doi:10.1001/archinte.162.13.1442

THE TERMS idiopathic low back pain and nonspecific low back pain(hereinafter idiopathic LBP and nonspecific LBP), which achieved prominence at least 20 years ago, are commonly used to describe the condition of up to 85% of patients for whom a specific diagnosis is said to be impossible. These concepts, the basis of the current national consensus on the diagnosis and treatment of LBP, have been accepted as true without attempts at replication or critical analysis. We find the original studies flawed and inadequate to support the assertions that most LBP cannot be diagnosed. We herein demonstrate that the concept of idiopathic LBP lacks sufficient evidence to remain valid and offer a viable alternative model.