Oxford Textbook of Medicine
6th Edition, Volume 3, Page 4406

Summary

Over 70% of people in industrialized countries suffer from low back pain at some time, and it is one of the main reasons for visits to physicians. Risk factors include heavy physical work, smoking, stress, depression, and job dissatisfaction. In more than 90% of cases the exact anatomical source of back pain cannot be determined, and the preferred diagnostic label is ‘non-specific low back pain’. Investigation should be restricted to patients with red flags and clinical suspicion of serious disease, with magnetic resonance imaging the best imaging modality for the diagnosis of lumbar disorders. In the absence of red flags, patients with acute low back pain should receive non pharmacological care as first treatment option including reassurance, advise to remain active, massage and spinal manipulation followed by non steroidal anti-inflammatory drugs and muscle relaxants if necessary.

By: Carlo Ammendolia and Danielle Southerst.