Low Back Pain Handbook. A Guide for the Practicing Clinician by Andrew J. Cole, M.D., F.A.C.S.M. and Stanley A. Herring,

By Andrew J. Cole, M.D., F.A.C.S.M. and Stanley A. Herring, M.D., F.A.C.S.M. (Eds.)

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Extra resources for Low Back Pain Handbook. A Guide for the Practicing Clinician

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C. This process is called kindling, which can lead to permanent brain dysfunction after as few as three traumatic events in a lifetime. D. Just as concussions are graded based on the frequency and degree of brain injury, so too are psychic, emotional, and physical injuries graded based on the frequency, nature, and severity of the life experience. E. Depressed patients have recurring negative and hopeless thoughts often not accurately reflecting reality. The anxious patient has recurrent thoughts of self-doubt not accurately reflecting reality.

Annual incidence is 5%. C. Although up to 90% of injured workers improve within 3 months, up to 90% of them suffer from recurring pain. D. 40% of patients with low back pain report pain at 6-month follow-up. E. 10% of work injury claims account for 80% of the cost, with 50% of these individuals having no objective physical findings. F. Nine million Americans are disabled by low back pain. G. 67% of chronic low back pain sufferers have experienced major depression prior to their low back injury; 36% had a history of substance abuse before the injury occurred.

2. Paranoid, borderline, avoidant, and passive/aggressive personality styles. a. Overreact to actual or vague perceptions of threat in their environment. b. They respond to common somatic symptoms with exaggerated emotional and physical reports of discomfort. c. Exhibit high levels of emotional and functional impairment with chronic pain. d. Often present with mood, adjustment, anxiety, or symptoms of pathology when confronted with the stress of chronic pain. 3. Histrionic and narcissistic personalities.

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