Low back pain – current concepts

Low back pain is a common musculosceletal disorder affecting 80% of people at some point of their life. It can be either acute, subacute or chronic in duration. In the minority of cases it may occur as a symptom of serious medical condition (trauma, cancer, epidural inflammation, compression radiculopathy, cauda equina syndrome etc) and requires urgent diagnostic testing and treatment. In the case of recurrent, subacute and chronic low back pain X-ray spondylograms  and imaging testing (preferably MRI) are needed.

Treatment of low back pain should be complex involving physical exercise and use of NSAID medication. Spinal manipulations, acupuncture, injections, and massage are not superior to standard conservative management. Surgery may be indicated when conservative treatment is not effective in the case of functionally limiting neurologic symptoms (leg weakness, caude equina syndrome).

Eesti Arst 2010; 89(1):32−39