セルフケアおよび患者教育(情報提供)も重要である[1]。「体の活動性を維持し、運動を行い、あまり休まずに、仕事を続けるように」とアドバイスを受けると、腰痛の予後は改善する[52]。正しい情報を与え安心させると予後は改善し、怖がらせて不安を与えると予後は悪化する[53]。「Know pain, or no gain」(痛みについて学べ。そうしなければ進展は無い)という標語がある。
人類は、銅器時代以来、腰痛と共にあった。外科の論文として最古のものは、紀元前1500年ごろのもので、Edwin Smith Papyrusが、脊椎捻挫を診断するための検査について述べている。ヒポクラテス(紀元前460年-同370年)は、最初に坐骨神経痛や腰痛という言葉を使った。また、2世紀の中ごろから終盤にかけて活躍したガレンは、腰痛の概念についてやや詳しく記載した。人類の最初の千年の終わりごろまでは、医者は、背中の手術を試みることは無く、注意深く観察して待つように患者に勧めた。中世を通じて、実地医家は、腰痛は精神から生じるものと考えて医療を行った[99]。
エックス線写真のような新しい技術により、医師は診断のための新しい手段を手に入れた。エックス線写真は、あるケースでは、椎間板が腰痛の原因となることを明らかにした。1938年に整形外科医のJoseph S. Barrは、椎間板が関与する坐骨神経痛が、手術により改善したことを報告した[100]。この研究報告によって、1940年代には、腰痛の椎間板モデルが、支配的となり[99]、CTやMRIなどの新しい画像診断の援助を受けて、1980年代の文献の主流となった[100]。その後、椎間板のトラブルは腰痛の原因としては比較的まれであることが研究により明らかとなり、椎間板についての議論は下火となった。その時以来、医者は、多くのケースでは、腰痛の原因は特定されないことに気が付くようになり、また、多くの場合には、治療の有無に関わらず、6週から12週以内に、痛みは治まることに気が付くようになった[99]。
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