Feature Article

Nonspecific low back pain: manage initially with reassurance, activity and analgesia

Feature Article

Nonspecific low back pain: manage initially with reassurance, activity and analgesia

Steven J Kamper, Christopher G Maher, Rachelle Buchbinder

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Abstract

Evidence-based management of nonspecific low back pain involves reassurance about a favourable prognosis, advice to maintain daily activities and stay active, and the prescribing of simple analgesic medications.

Key Points

  • Low back pain is one of the most common and costly musculoskeletal conditions treated in primary care.
  • Patients accessing primary care for low back pain should be screened for serious pathologies such as cancer, fracture and systemic diseases, but these conditions are very rare in such patients.
  • Evidence supports the providing of reassurance about a likely good prognosis and advice to stay active, and the prescribing of simple analgesia. Most patients recover well when treated in this manner.
  • Routine imaging and bed rest are not recommended.