Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 3 complete abstracts (796 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Acute or chronic pain located in the posterior regions of the thorax; lumbosacral region; or the adjacent regions.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Back Pains; Pain, Back; Pains, Back; Back Ache; Ache, Back; Aches, Back; Back Aches; Backache.
Where it fits in the MeSH classification
- Broader topics
- Pain
- Narrower topics
- Failed Back Surgery Syndrome; Low Back Pain
- See also
- Low Back Pain
Related concepts
- Thorax
- Lumbosacral Region
Research landscape
PubMed indexes 50,054 records tagged with the MeSH heading “Back Pain” (counts retrieved 2026-10-29). 11,100 of them (22.2%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 15,840 records.
Reviews account for 6,615 records (13.2%) and meta-analyses for 1,097. Randomized controlled trials number 4,470 (8.9%) as a share of all records on the topic. Randomized trials make up a comparatively large share of this literature, which means many treatment questions have been tested directly.
Show the data
| Period | Records |
|---|---|
| through 1999 | 12,596 |
| 2000-2009 | 10,518 |
| 2010-2019 | 15,840 |
| 2020 onward | 11,100 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 6,615 | 13.2% |
| Meta-analyses | 1,097 | 2.2% |
| Randomized controlled trials | 4,470 | 8.9% |
Method: PubMed query "Back Pain"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in neuroscience
Neuroscience draws on tools with different strengths: cellular and animal work can manipulate circuits directly, while human imaging and electrophysiology observe the living brain at lower resolution. Small imaging studies are prone to false positives, and findings in animals do not always carry over to people. Clinical neurology and psychiatry rely on trials and cohort studies whose outcomes are often symptom scales. Check the species, the sample size, how the outcome was measured and whether results were replicated.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Association between pain, physical performance, and kinesiophobia in older women with low back pain: A cross-sectional study | 2026 | Research article Design not recorded in structured metadata | 5 | cc by PMID 41758814 · DOI · PMC12948069 |
| Model-based economic evaluation of pharmacopuncture for chronic low back pain: a 3-year Markov analysis | 2025 | Research article Design not recorded in structured metadata | 3 | cc by PMID 41613092 · DOI · PMC12850513 |
| Akkermansia muciniphila attenuates intervertebral disc degeneration via extracellular vesicle-mediated delivery of the effector protein B2UKX5 | 2026 | Research article Design not recorded in structured metadata | 2 | cc by PMID 42161908 · DOI · PMC13190703 |
Association between pain, physical performance, and kinesiophobia in older women with low back pain: A cross-sectional study [1]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundKinesiophobia is a psychological element that may contribute to persistent pain and functional decline in older women with chronic low back pain.
- Closing excerpt
- Given the cross-sectional design, causal inferences should be drawn cautiously.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (262 words)
BackgroundKinesiophobia is a psychological element that may contribute to persistent pain and functional decline in older women with chronic low back pain. Clarifying its role could inform more effective rehabilitation strategies.ObjectivesTo examine associations between kinesiophobia, pain intensity, and physical performance in older women with chronic low back pain.MethodsA cross-sectional study was conducted in 2024 with 119 women aged ≥ 60 years reporting nonspecific low back pain. Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia (TSK-17), and pain with the Visual Analog Scale (VAS). The Timed Up and Go test and the 30-second sit-to-stand test were performed to evaluate balance and lower limb strength, respectively (physical performance). Correlation, regression, and mediation analyses were used to explore relationships among variables.ResultsHigher pain intensity was strongly associated with higher kinesiophobia (β = 0.74, p = 0.001), while lower limb strength showed a negative association (β = -0.17, p = 0.005). No significant relationship emerged between kinesiophobia and balance (p > 0.05). Regression indicated that pain was the strongest predictor of kinesiophobia. Mediation analyses suggested that kinesiophobia fully explained the relationship between pain and reduced lower limb strength, while strength itself partially mediated the link between pain and kinesiophobia, highlighting both direct and indirect effects.ConclusionsIn older women with chronic low back pain, kinesiophobia is positively related to pain severity and negatively related to lower limb strength, but not balance. Findings suggest fear of movement may mediate the impact of pain on physical performance, underscoring the importance of addressing psychological as well as physical factors in rehabilitation. Given the cross-sectional design, causal inferences should be drawn cautiously.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41758814 · DOI · PMC12948069
Model-based economic evaluation of pharmacopuncture for chronic low back pain: a 3-year Markov analysis [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundChronic low back pain (cLBP) is the leading cause of disability worldwide and a major driver of healthcare costs.
- Closing excerpt
- This aligns with WHO priorities for evidence-based integration of traditional medicine, supports policy discussions on equitable coverage, and informs sustainable chronic pain management strategies across health systems.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (324 words)
BackgroundChronic low back pain (cLBP) is the leading cause of disability worldwide and a major driver of healthcare costs. Excessive reliance on pharmacological treatments raises sustainability and safety concerns, highlighting the need for effective non-pharmacological alternatives. Pharmacopuncture (PPT), also known as herbal acupuncture or acupoint injection therapy, is widely practiced in some Asian countries (e.g., Korea and China) but remains uninsured in most health systems and largely excluded from international guidelines despite its clinical adoption. Evidence on its long-term cost-effectiveness compared with standard physiotherapy (PT) is limited.ObjectiveTo evaluate the cost-utility of PPT versus PT for patients with cLBP using a Markov model designed in accordance with international pharmacoeconomic guidelines and standard government requirements for cost-effectiveness analysis.MethodsA three-state Markov model (mild, moderate, severe pain) projected outcomes over 3 years with 3-month cycles. Clinical inputs were derived from a multicenter pragmatic RCT. Costs were estimated from healthcare system, restricted societal, and full societal perspectives, incorporating medical, non-medical, and productivity loss costs estimated using national health databases. Quality-adjusted life years (QALYs) were calculated using EQ-5D-5L data. Incremental cost-effectiveness ratios (ICERs) were benchmarked against the Korean willingness-to-pay (WTP) threshold. Deterministic and probabilistic sensitivity analyses assessed robustness.ResultsOver 3 years, PPT was less costly and more effective than PT. From the healthcare perspective, PPT reduced costs ($1,304 vs. $1,385) while yielding higher QALYs (2.30 vs. 2.23), resulting in dominance (ICER = -$1,145 per QALY). From the societal perspective, including productivity, PPT further strengthened its dominance ($25,760 vs. $31,962). Probabilistic sensitivity analysis showed a 97.7% (healthcare) and 99.4% (societal) probability of cost-effectiveness at the WTP threshold. Results were robust across sensitivity scenarios.ConclusionThis is the first model-based economic evaluation of pharmacopuncture for cLBP. Findings indicate that PPT can deliver higher QALYs at lower costs compared with PT, underscoring its potential as a high-value non-pharmacological alternative. This aligns with WHO priorities for evidence-based integration of traditional medicine, supports policy discussions on equitable coverage, and informs sustainable chronic pain management strategies across health systems.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41613092 · DOI · PMC12850513
Akkermansia muciniphila attenuates intervertebral disc degeneration via extracellular vesicle-mediated delivery of the effector protein B2UKX5 [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Low back pain is a leading cause of global disability, with intervertebral disc degeneration (IVDD) as a primary contributor.
- Closing excerpt
- These findings establish a novel gut-disc axis, highlighting Akk, Akk-EVs, and B2UKX5 as promising therapeutic candidates for IVDD prevention and treatment.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (210 words)
Low back pain is a leading cause of global disability, with intervertebral disc degeneration (IVDD) as a primary contributor. Emerging evidence suggests a link between gut microbiota and disc health, yet the underlying mechanisms remain unclear. Through Mendelian randomization and a clinical cohort analysis, we identified a causal inverse relationship between Akkermansia muciniphila (Akk) abundance and IVDD risk, with reduced fecal Akk levels correlating with increased IVDD severity. Akk protected against IVDD in microbiota-depleted mice, and this protection was abolished by pharmacologic inhibition of extracellular vesicle (EV) secretion. Consistently, Akk-derived EVs (Akk-EVs) recapitulated the benefits of Akk across natural aging, tail needle puncture, and bipedal standing mouse models, while control bacterium (Escherichia coli) and its EVs did not. Proteomics and functional validation identified B2UKX5 as a key Akk-EV-enriched effector protein. Furthermore, recombinant B2UKX5 attenuated IVDD in vivo and regulated critical pathways for disc homeostasis, including collagen synthesis, extracellular matrix remodeling, and chromatin silencing, as revealed by transcriptomic profiling of microdissected nucleus pulposus and annulus fibrosus tissues. Analysis of clinical samples further confirmed that Akk-EVs and B2UKX5 levels in circulation and intervertebral disc tissues were negatively correlated with IVDD severity. These findings establish a novel gut-disc axis, highlighting Akk, Akk-EVs, and B2UKX5 as promising therapeutic candidates for IVDD prevention and treatment.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42161908 · DOI · PMC13190703
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Exercise therapy for chronic low back pain [4]
- Research article Prevalence, Incidence, and Factors Associated With Non-Specific Chronic Low Back Pain in Community-Dwelling Older Adults Aged 60 Years and Older: A Systematic Review and Meta-Analysis [5]
- Research article Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis [6]
- Research article Best Exercise Options for Reducing Pain and Disability in Adults With Chronic Low Back Pain: Pilates, Strength, Core-Based, and Mind-Body. A Network Meta-analysis [7]
- Research article Global and regional estimates of clinical and economic burden of low back pain in high-income countries: a systematic review and meta-analysis [8]
- Research article Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis [9]
References
- Saki F, Ramezani F, Taheri R. Association between pain, physical performance, and kinesiophobia in older women with low back pain: A cross-sectional study. . 2026. PMID 41758814 · DOI · PMC12948069
- Lee YS, Kim S, Ha IH, Lee YJ. Model-based economic evaluation of pharmacopuncture for chronic low back pain: a 3-year Markov analysis. . 2025. PMID 41613092 · DOI · PMC12850513
- Guan Z, Li X, Chen Y, Zhu S, Wen J, Zhou H, et al.. Akkermansia muciniphila attenuates intervertebral disc degeneration via extracellular vesicle-mediated delivery of the effector protein B2UKX5. . 2026. PMID 42161908 · DOI · PMC13190703
- Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021. PMID 34580864 · DOI · PMC8477273
- Wong CK, Mak RY, Kwok TS, Tsang JS, Leung MY, Funabashi M, et al.. Prevalence, Incidence, and Factors Associated With Non-Specific Chronic Low Back Pain in Community-Dwelling Older Adults Aged 60 Years and Older: A Systematic Review and Meta-Analysis. J Pain. 2022. PMID 34450274 · DOI
- Hayden JA, Ellis J, Ogilvie R, Stewart SA, Bagg MK, Stanojevic S, et al.. Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. J Physiother. 2021. PMID 34538747 · DOI
- Fernández-Rodríguez R, Álvarez-Bueno C, Cavero-Redondo I, Torres-Costoso A, Pozuelo-Carrascosa DP, Reina-Gutiérrez S, et al.. Best Exercise Options for Reducing Pain and Disability in Adults With Chronic Low Back Pain: Pilates, Strength, Core-Based, and Mind-Body. A Network Meta-analysis. J Orthop Sports Phys Ther. 2022. PMID 35722759 · DOI
- Fatoye F, Gebrye T, Ryan CG, Useh U, Mbada C. Global and regional estimates of clinical and economic burden of low back pain in high-income countries: a systematic review and meta-analysis. Front Public Health. 2023. PMID 37383269 · DOI · PMC10298167
- Ho EK, Chen L, Simic M, Ashton-James CE, Comachio J, Wang DXM, et al.. Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis. BMJ. 2022. PMID 35354560 · DOI · PMC8965745
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.