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Low Back Pain and Lumbar Strains, Sports Medicine

John Kiel, DO, MPH and M. Kyle Smoot, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Acute low back pain is pain of <3 mo duration localized below the costal margin but above the inferior gluteal folds with or without leg pain.

  • Synonym(s): lumbar strain; lumbar spr...

DIAGNOSIS

HISTORY

  • Initial history should focus on the patient’s age and pain characteristics (onset, duration, severity, quality, radiation, aggravating factors, alleviating factors).

  • Question patient a...

TREATMENT

  • Natural history of MBP, regardless of treatment: 33% resolve within 1 wk, 70% resolve within 1 mo, and 90–95% resolve within 3 mo.

  • Analgesia:

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Begin walking as soon as possible.

  • Early osteopathic or chiropractic referral is often beneficial.

  • Early orthopedic or physical therapy referral is rarely indicated...

REFERENCES

1
Chaparro LE, Furlan AD, Deshpande A, et al. Opioids compared with placebo or other treatments for chronic low back pain: an update of the Cochrane review. Spine (Phila Pa 1976).  2014...

ADDITIONAL READING

Vijan S, Manaker S, Qaseem A. Noninvasive treatments for acute, subacute, and chronic low back pain. Ann Intern Med.  2017;167(11):835–836. 

CLINICAL PEARLS

  • Acute low back pain is the most common musculoskeletal complaint seen by primary care providers associated with a significant morbidity, health care cost, and missed work.

  • In the absenc...

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