Juniper M, Le TK, Mladsi D. The epidemiology, economic burden, and pharmacological treatment of chronic low back pain in France, Germany, Italy, Spain and the UK: a literature-based review. Expert Opin Pharmacother. 2009 Nov 1;10(16):2581-92. doi: 10.1517/14656560903304063.

OBJECTIVE: This study's objective was to review the literature on the epidemiological and economic burden and treatment of chronic low back pain (CLBP) in France, Germany, Italy, Spain and the UK.

METHODS: A literature search was conducted for 1997 - 2007, focusing on CLBP burden and treatment in the countries of interest.

RESULTS: The literature search yielded 1552 articles; 23 sources were included in this review. General population prevalence estimates for CLBP were available for two countries: 5.91% (Italy) and 6.3 - 11.1% (UK). Resource utilization estimates were available for Germany, Italy, Spain and the UK. Patients visited general practitioners and osteopaths. Annual direct costs of low back pain were available only for Germany: > euro 7000 per person. Work absenteeism accounted for 75% of the total per-patient cost of low back pain in Germany. The five identified treatment guidelines recommended a multimodal approach. Recommended pharmacotherapies included NSAIDs, muscle relaxants, analgesics and anesthetics, and opioids.

CONCLUSIONS: Prevalence estimates varied, possibly owing to differences in diagnostic criteria and populations studied. Little is known about CLBP's economic burden. Treatment guidelines recommended multimodal treatment.

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