Symptoms, pathology, and radiological appearances are poorly correlated. Pain is non-specific in
about 85% of people. About 4% of people with low back pain in primary care have compression
fractures, and about 1% have a tumour. The prevalence of prolapsed intervertebral disc among
people with low back pain in primary care is about 1% to 3%. [3] Ankylosing spondylitis and spinal
infections are less common. [5] This review only covers chronic low back pain where a definitive
diagnosis cannot be made. Risk factors include heavy physical work; frequent bending, twisting,
and lifting; and prolonged static postures. Psychosocial risk factors include anxiety, depression,
and mental stress at work. [3] [6] Having a previous history of low back pain and a longer duration
of the present episode are significant risk factors for chronicity. One systematic review of
prospective cohort studies found that some psychological factors (distress, depressive mood, and
somatisation) are associated with an increased risk of chronic low back pain. [7] Individual and
workplace factors have also been reported to be associated with the transition to chronic low back
pain.