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Back Pain, Low

Michael Maddaleni, MD and J. Herbert Stevenson, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Low back pain (LBP) is extremely common and includes a wide range of symptoms involving the lumbosacral spine and pelvic girdle.

  • Characterized by duration or associated symptoms

  • Durati...

DIAGNOSIS

HISTORY

  • Onset of pain (sudden or gradual) (1)[A]

  • Pain from spinal structures (musculature, ligaments, facet joints and disks) can refer to the thigh region but rarely below the knee. However, ...

TREATMENT

The primary goal is to provide supportive care and allow return to functional activity. Patients should be aware of alarm symptoms to prompt a return visit. 

MEDICATION

First Line

  • Physical ther...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Regular exercise to manage weight and control symptoms (3)[A]

  • Educate patients regarding chronicity, recurrence, and red flags (3)[A].

Patient Monitoring

  • Reassurance...

REFERENCES

1
1 Golob AL, Wipf JE. Low back pain. Med Clin North Am.  2014;98(3):405–428. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 Delitto A, George SZ, Van Dillen, et al; for Orthopaedi...

ADDITIONAL READING

  • Andronis L, Kinghorn P, Qiao S, et al. Cost-effectiveness of non-invasive and non-pharmacological interventions for low back pain: a systematic literature review. Appl Health Econ H...

SEE ALSO

  • Algorithm: Low Back Pain, Acute

CODES

ICD10

  • M54.5 Low back pain

  • G89.29 Other chronic pain

  • M53.3 Sacrococcygeal disorders, not elsewhere classified

  • M53.3 Sacrococcygeal disorders, not elsewhere classified

  • M54.40 Lumbago with sciatica, uns...

CLINICAL PEARLS

  • LBP is one of the most common complaints in primary care. Most cases resolve spontaneously within 4 to 12 weeks of onset.

  • Assess for red flag symptoms in every patient, such as bowel/bl...

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