Treatment of acute low back pain
- Christopher L Knight, MD
Christopher L Knight, MD
- Associate Professor of Medicine
- University of Washington
- Richard A Deyo, MD, MPH
Richard A Deyo, MD, MPH
- Professor of Medicine and Family Medicine
- Oregon Health & Science University
- Thomas O Staiger, MD
Thomas O Staiger, MD
- Professor of Medicine
- University of Washington School of Medicine
- Joyce E Wipf, MD
Joyce E Wipf, MD
- Professor of Medicine
- University of Washington
It is estimated that up to 84 percent of adults have low back pain at some time in their lives [1,2]. The vast majority of patients seen in primary care (>85 percent) will have nonspecific low back pain, meaning that the patient has back pain in the absence of a specific underlying condition that can be reliably identified [3-5]. For most of these individuals, episodes of back pain are self-limited. Patients who continue to have back pain beyond the acute period (four weeks) have subacute back pain (lasting between 4 and 12 weeks), and some may go on to develop chronic back pain (lasting >12 weeks) .
This discussion focuses on the initial treatment of nonspecific acute back pain. The treatment of acute low back pain from specific conditions is discussed in the appropriate topics. As examples:
●Treatment for vertebral compression fracture (see "Osteoporotic thoracolumbar vertebral compression fractures: Clinical manifestations and treatment")
●Treatment for lumbosacral radiculopathy (see "Acute lumbosacral radiculopathy: Treatment and prognosis")
●Treatment for lumbar spinal stenosis (see "Lumbar spinal stenosis: Treatment and prognosis")To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- GENERAL APPROACH TO CARE
- NONPHARMACOLOGIC THERAPIES
- Spinal manipulation
- Exercise and physical therapy
- Initial therapy
- - Nonsteroidal antiinflammatory drugs
- - Limited benefit of acetaminophen
- Second-line therapy
- - Combination with muscle relaxants
- Refractory or severe pain
- - Opioids
- - Tramadol
- Other medications
- PATIENT EDUCATION
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS