low%20back%20pain
LOW BACK PAIN
Treatment Guideline Chart
It is pain, stiffness, or discomfort in the lower back area below the costal margin and above the gluteal creases.
Low back pain is also called spinal pain or lumbago.
Nonspecific low back pain is without identifiable specific causes and makes up 90-95% of all low back pain cases.  It also includes pain felt in the proximal lower extremities.
Patients with low back pain may have mobility deficits caused by severe or progressive neurologic disorders or comorbidities.
Specific spinal pathology includes cauda equina syndrome, tumor, infection, ankylosing spondylitis, or inflammatory disorders.
Low back pain associated with radiculopathy or spinal stenosis is dermatomal pain with or without neurologic deficits that is most often caused by nerve root compression.

Low%20back%20pain Patient Education

Patient Education

  • Proper sleeping and work posture should be encouraged
    • It is encouraged to maintain maximal work and daily living activities
  • Brief educational interventions are recommended for patients with chronic low back pain
    • Encourages return to normal activity during attacks to avoid disability and filing for sick leaves
    • Pain neurophysiology education, a type of pain education concentrating on the psychosocial and neurophysiological contributors of pain, has been shown to improve chronic low back pain in some trials 
  • Back schools may be utilized for temporary (<6 weeks) pain relief
    • Superior to placebo for acute or subacute low back pain
    • Studies have also concluded that worksite-specific back schools are considered effective
    • More effective when added to exercise and physical treatment in patients with chronic low back pain
  • Bed rest should be avoided in patients with acute low back pain
    • Bed rest is advised only for unstable spinal fracture 
    • Gradual return to normal activities is found to be more beneficial than prolonged bed rest
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