The hallmarks of new evidence-based approaches to assessing and treating acute low back pain are limited use of medical imaging, appropriate use of analgesia and an emphasis on patient education as a means to self-management. Risk stratification enables early identification and appropriate treatment of patients who are most likely to develop chronic pain.
Low back pain (LBP) is pain occurring between the gluteal crease and below the twelfth rib that may or may not be accompanied by features of lumbar radicular involvement. Based on the duration of the episode, patients can be classified as having acute (less than three months’ duration) or chronic (greater than three months’ duration) LBP. Acute LBP is common and has an excellent prognosis, with almost half of affected patients recovering within a few weeks; however, about 15% may have symptoms persisting beyond 12 months.
The most common form of LBP is nonspecific LBP. A diagnosis of nonspecific LBP is made when there are no signs of a serious underlying condition such as a vertebral compression fracture, infection or cancer, and no nerve root involvement is being considered.
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