Low back pain: an approach to diagnosis and management.
Low back pain is a common condition, responsible for significant morbidity and major occupational and economic impact on society. While most cases of low back pain spontaneously resolve, the clinician must be alert to clinical indicators or "red flags" that suggest the presence of systemic illness or imminent neurologic compromise. In the absence of such findings, diagnostic imaging generally does not contribute to management, and may be safely delayed for a trial of conservative therapy. Continued activity is associated with a favorable outcome. Nonsteroidal anti-inflammatories, acetaminophen, muscle relaxants, and tricyclic antidepressants can provide meaningful pain relief, while several nonpharmacologic measures may also contribute to symptomatic and functional improvement.
Department of Family Medicine, University of South Alabama, 1504 Springhill Avenue, Suite 3414, Mobile, AL 36604, USA. rlduffy@usouthal.edu
R Lamar
RL
Duffy
D000082:Acetaminophen / Q000627:therapeutic use; D000465:Algorithms; D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001772:Blood Cell Count; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D003937:Diagnosis, Differential; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D012585:Sciatica / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000929:Antidepressive Agents, Tricyclic; D009125:Muscle Relaxants, Central; D000082:Acetaminophen; D002097:C-Reactive Protein