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Feature Article

The significance of chronic back pain

Les Barnsley

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Abstract

Patients with a serious disorder may present with chronic back pain but the condition is more often due to an unspecified mechanical dysfunction. Exercise and analgesics are the treatments of choice in patients with chronic back pain.

Key Points

  • More than 70% of people report significant episodes of back pain at some point in their lives.
  • A patient with uncomplicated back pain, no history suggestive of a serious underlying disorder and no history or examination findings suggestive of neurological involvement does not warrant further investigation.
  • Imaging of patients with chronic back pain should not be performed in a nontargeted fashion.
  • There is good evidence that a range of exercise interventions are effective for decreasing the frequency of recurrences of back pain.
  • Short-term use of analgesics and NSAIDs in patients with acute exacerbations of low back pain can facilitate maintenance of activity.

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