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Back Pain, Low

Ashley Koontz Sturts, DO Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Low back pain (LBP) is a common chief complaint presenting to primary care and acute care settings

    • 2.5 million were diagnosed with LBP in the USA between 2008–2015 (1)

    • Annual expendit...

DIAGNOSIS

HISTORY

  • Onset of pain (sudden or gradual)

  • Inciting event, injury, or trauma

  • Frequency of pain (episodic or constant with or without fluctuation)

  • Characterization and location of pain:

    • Facet pain ...

TREATMENT

GENERAL MEASURES

  • Multidisciplinary bio-psychosocial approach is encouraged

  • First line management: activity modification, early return to routine duties, physical therapy

MEDICATION

First Line

NSA...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Initial follow up is recommended in 2–4 weeks for acute flare

  • Longer interval follow up of 6–12 weeks may be beneficial for chronic LBP

REFERENCES

1
Knezevic NN, Candido KD, Vlaeyen JWS, et al. Low back pain. Lancet. 2021;398(10294):78-92. doi: 10.1016/S0140-6736(21)00733-9. PMID: 34115979.
2
Bailly F, Trouvin MA, Bercier S, et al. Clini...

ADDITIONAL READING

  • Almeida MO, Narciso Garcia A, Menezes Costa LC, et al. The McKenzie method for (sub)acute non-specific low back pain. Cochrane Database Syst Rev. 2023;4(4):CD00...

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

  • Low back pain is a common cause for health care expenditure, disability and loss of productivity worldwide

  • If no alarm symptoms are present, imaging is not beneficial in initial workup

  • C...

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