在美国,下腰痛是第二位最常见就诊原因。[2]Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987;12:264-268.http://www.ncbi.nlm.nih.gov/pubmed/2954221?tool=bestpractice.com一生中发生率接近50%-84%。[3]Cassidy JD, Carroll LJ, Cote P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine. 1998;23:1860-1866.http://www.ncbi.nlm.nih.gov/pubmed/9762743?tool=bestpractice.com[4]Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin. 2007;25:353-371.http://www.ncbi.nlm.nih.gov/pubmed/17445733?tool=bestpractice.com[5]Manchikanti L. Epidemiology of low back pain. Pain Physician. 2000;3:167-192.http://www.painphysicianjournal.com/current/pdf?article=MzMx&journal=3http://www.ncbi.nlm.nih.gov/pubmed/16906196?tool=bestpractice.com2002 年美国国家健康访问调查 (US National Health Interview Survey) 显示,26% 美国人在最近的三个月中出现至少 1 天下腰痛。[6]Deyo RA, Mirza SK, Martin BI. Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine. 2006;31:2724-2727.http://www.ncbi.nlm.nih.gov/pubmed/17077742?tool=bestpractice.com基于英国人口的调查显示,人群中1个月期间内出现下腰痛的患病率为35%-37%。[7]Papageorgiou AC, Croft PR, Ferry S, et al. Estimating the prevalence of low back pain in the general population. Evidence from the South Manchester Back Pain Survey. Spine. 1995;20:1889-1894.http://www.ncbi.nlm.nih.gov/pubmed/8560337?tool=bestpractice.com发病率差别很大。年发病率通常介于 4% 至 93% 之间。[4]Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin. 2007;25:353-371.http://www.ncbi.nlm.nih.gov/pubmed/17445733?tool=bestpractice.com加拿大萨斯喀彻温省的队列研究显示下腰痛年发生率为18.6%,大部分均为轻度疼痛。[3]Cassidy JD, Carroll LJ, Cote P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine. 1998;23:1860-1866.http://www.ncbi.nlm.nih.gov/pubmed/9762743?tool=bestpractice.com美国退伍军人事务部(US Veterans Affairs)统计显示,3年内,门诊出现任何程度、时长下腰痛的发生率为67%。[8]Jarvik JG, Hollingworth W, Heagerty PJ, et al. Three-year incidence of low back pain in an initially asymptomatic cohort: Clinical and imaging risk factors. Spine. 2005;30:1541-1548.http://www.ncbi.nlm.nih.gov/pubmed/15990670?tool=bestpractice.com
下腰痛复发比较常见。急性下腰痛一年内出现复发性或转为慢性下腰痛的比例为35%-75%,但相当一部分有持续疼痛的患者放弃继续就医。[5]Manchikanti L. Epidemiology of low back pain. Pain Physician. 2000;3:167-192.http://www.painphysicianjournal.com/current/pdf?article=MzMx&journal=3http://www.ncbi.nlm.nih.gov/pubmed/16906196?tool=bestpractice.com[9]Croft PR, Macfarlane GJ, Papageorgiou AC, et al. Outcome of low back pain in general practice: a prospective study. BMJ. 1998;316:1356-1359.http://www.bmj.com/content/316/7141/1356.fullhttp://www.ncbi.nlm.nih.gov/pubmed/9563990?tool=bestpractice.com
女性下腰痛发生率略高于男性。[10]Kopec JA, Sayre EC, Esdaile JM. Predictors of back pain in a general population cohort. Spine. 2004;29:70-77.http://www.ncbi.nlm.nih.gov/pubmed/14699279?tool=bestpractice.com下腰痛好发年龄为20-65岁。其中20-35岁发生率相对较低,之后逐渐上升直至60-65岁,更高龄人群发病情况尚不清楚。[4]Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin. 2007;25:353-371.http://www.ncbi.nlm.nih.gov/pubmed/17445733?tool=bestpractice.com[11]Shelerud RA. Epidemiology of occupational low back pain. Clin Occup Environ Med. 2006;5:501-528.http://www.ncbi.nlm.nih.gov/pubmed/16963373?tool=bestpractice.com[12]Dionne CE, Dunn KM, Croft PR. Does back pain prevalence really decrease with increasing age? A systematic review. Age Ageing. 2006;35:229-234.http://www.ncbi.nlm.nih.gov/pubmed/16547119?tool=bestpractice.com各种族腰痛发生率无明显差异。2002年美国国家健康调查显示,美国本土人及阿拉斯加本土人下腰痛的患病率最高,而亚裔美国人最低(三个月期间内发病率分别为35%与19%)。[13]Cassidy JD, Cote P, Carroll LJ, et al. Incidence and course of low back pain episodes in the general population. Spine. 2005;30:2817-2823.http://www.ncbi.nlm.nih.gov/pubmed/16371911?tool=bestpractice.com