Oh My Aching Back

Low back pain is the fifth most common reason for all physician visits in the United States.

Low back pain is the fifth most common reason for all physician visits in the United States. Many patients have self-limited episodes of acute low back pain and many improve rapidly in the first month. For patients with acute low back pain it is recommended that providers:

• Do not obtain imaging or other diagnostic tests in the first month following the diagnosis unless there is evidence of severe or progressive neurological deficits.

• Provide patients with evidence based information on low back pain such as expected course and self-care options.

Helpful Hints for Your Practice

• Provide patients with low back pain evidence-based information about their expected course, advise patients to remain active, and provide information about effective self-care options.

• Assess severity of baseline pain and functional deficits and discuss potential benefits and risks before initiating therapy.

• Do not routinely obtain imaging or other diagnostic tests in patients with non-specific low back pain.

• Conduct a focused history and physical examination to help place patients with low back pain into one of three broad categories: non-specific low back pain, back pain potentially associated with radiculopathy, or spinal stenosis or back pain potentially associated with another specific spinal cause. The history should include assessment of psychosocial risk factors, which predict risk for chronic disabling back pain.