A serious underlying condition rarely is present in patients with low back pain (LBP), but the pain can be intense and severely limit home and work activities. For most patients with LBP, the cause is a nonspecific mechanical process; for those with acute symptoms, the course is self–limited. Initial treatments include activity modification, nonnarcotic analgesic agents, and patient education. For patients whose symptoms are not improving, referral for physical treatments is appropriate. For patients with subacute and chronic LBP, behavioral treatments, exercise programs, spinal manipulation, and multidisciplinary rehabilitation can help. For patients with chronic LBP, a variety of other therapeutic options (eg, acupuncture) also are effective. Primary care physicians may help patients by providing unbiased information and redirecting care for those who are not improving.
The Journal of Musculoskeletal Medicine, 02/05/10
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