Skip to main content
General Medicine

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
Golob AL, Wipf JE. Low back pain. Med Clin North Am.  2014;98(3):405–428. [View Abstract on OvidMedline]
2
Delitto A, George SZ, Van Dillen, et al; for Orthopaedic Section of the Ameri...

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...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

START 10-DAY FREE TRIAL
Subscribe Now
GET CME/CE
Related Images
Left Arrow Button Right Arrow Button
FIG. 63.2. Anteroposterior radiograph of the upper pelvis and lumbar spine. Both sacroiliac joints (large arrows) are fused (grade IV sacroiliitis), and there are bilateral, symmetric syndesmophytes (small arrow), resulting in the typical "bamboo" appearance of ankylosing spondylitis.
FIG. 63.2. Anteroposterior radiograph of the upper pelvis and lumbar spine. Both sacroiliac joints (large arrows) are fused (grade IV sacro...
FIGURE 9-44. Lumbar spondylolysis. Imaging of the lumbar spine in four separate patients with low back pain, two with L4 spondylolysis (A,B,C,D,E) and two with L5 spondylolysis (F,G,H,I,J,K) demonstrates the multimodality approach to imaging when assessing for spondylolysis/spondylolisthesis. Conventional lumbar radiographs, including lateral and bilateral obliques (A,B,C) nicely demonstrate the bony break (arrows in A) within the region of the bilateral L...
FIGURE 9-44. Lumbar spondylolysis. Imaging of the lumbar spine in four separate patients with low back pain, two with L4 spondylolysis (A,B...
Causes of Low Back Pain Sagittal View Labeled
Causes of Low Back Pain Sagittal View Labeled
FIG. 9 A: Low back pain with small contained prolapse, L-5 to S-1, and high signal-intensity zone at L4-5. B,C: Major concordant pain responses by clinical distention at each level.
FIG. 9 A: Low back pain with small contained prolapse, L-5 to S-1, and high signal-intensity zone at L4-5. B,C: Major concordant pain respo...
    ×
     
    ©2019 Wolters Kluwer Health, Inc. and/or its affiliates. All rights reserved.

    Enter An Access Code

     
    We are unable to redeem your access code. Please try again another time.
    Enter the code from your copy of The 5-Minute Clinical Consult or another access code to create an account.
    ×
    ×
    This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept