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Back Pain, Low

Vasilios Chrisostomidis, DO Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Low back pain (LBP) is extremely common and is characterized by duration or associated symptoms

  • Duration

    • Acute (<6 weeks)

    • Subacute (>6 weeks but <3 months)

    • Chronic (>3 months...

DIAGNOSIS

HISTORY

  • Onset of pain (sudden or gradual)

  • Facet pain commonly radiates to sacroiliac joint/PSIS region.

  • Sacroiliac pain often refers to the thigh and can radiate below the knee.

  • Irritation, impi...

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

  • Strongly encourage patients to remain active.

Patient Monitoring

  • Reassurance is important. Follow up within 2 to 4 weeks of initial presentation to ...

REFERENCES

1
Will JS, Bury DC, Miller JA. Mechanical low back pain. Am Fam Physician. 2018;98(7):421–428.

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 re...

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

  • Most cases resolve spontaneously within 4 to 12 weeks of onset.

  • Assess for red flag symptoms, such as bowel/bladder incontinence, history of cancer, or recent trauma.

  • Labs and imaging st...

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