Pain is a highly prevalent and costly health problem in the United States. Back pain, in particular, affects at least 84% of individuals at some point during their lives [1, 2], and pain recurs in up to 80% of cases within 1 year . The pain can occur at any age but is most prevalent during the third decade of life . In the United States, back pain is the second most common cause of disability , the second leading cause of lost workplace productivity (after the common cold) , and the third most common reason for visiting a health provider . These effects place an enormous burden on U.S. society and health care systems, as reflected by an estimated cost ranging from $84.1 billion (direct cost of health care) to $624.8 billion (indirect cost including loss of productivity) per year [6–8]. Pain in its various manifestations is also responsible for work absences, which create an enormous economic burden on individuals, families, communities, industry, and government [1, 9].