[Evolution of the concepts about non specific low back pain].
During last years knowledge about assessment and management of non specific low back pain and their assumption of responsibility developed much. The hazardous anatomoclinic physiopathology is not any more setting. In at least 50% of the cases the precise cause of pain cannot be established. Acute non specific low back pain, in the very large majority of the cases, is a banal incident of the life. Its management rests on precise and reassuring information, withdrawal of the useless and harmful imaging techniques, optimal use of analgesic treatment, and on the early resumption of the activities. When, after sixth week, the favourable outcome did not clearly take shape, the management should be reinforced to avoid disability. In such a case, the principal problem is not any more the back pain itself, but the prolonged incapacity generated by the back pain, which requires a global and multidisciplinary management. One cannot recommend the surgery in low back pain without radicular involvement, except in some very particular and exceptional cases. The recent recommendations for the management of non specific low back pain appear to have involved a reduction of back pain disability.
Service de rhumatologie, hôpital Trousseau, Tours. valat@med.univ-tours.fr
Jean-Pierre
JP
Valat
D006801:Humans; D017116:Low Back Pain / Q000628:therapy*