Back Pain, Low
- Low back pain (LBP) is extremely common and includes a wide range of symptoms involving the lumbosacral spine and pelvic girdle.
- Characterized by duration or associated symptoms
- Acute (<6 weeks)
- Subacute (>6 weeks but <3 months)
- Chronic (>3 months)
- Localized/nonspecific “mechanical” LBP
- Back pain with lower extremity symptoms
- Systemic and visceral symptoms
- A specific cause is not found for most patients with LBP. Most cases resolve in 4 to 6 weeks.
- Rule out “red” flag symptoms indicating the need for immediate intervention.
- System(s) affected: musculoskeletal, neurologic
- Synonym(s): lumbago, lumbar sprain/strain, low back syndrome
- 1-year incidence for first episode: 6.3–15.3% (2)
- 1-year incidence for any episode: 1.5–3.6% (2)
- A very common primary care complaint (1)
Etiology and Pathophysiology
LBP can be commonly due to muscle spasm/tension. Estimated 39% of chronic LBP due to disk degeneration. 30% estimated to be from facet joint syndrome. Other possibilities include sacroiliac injuries/degeneration and spinal stenosis. Age-related degenerative changes of the lumbosacral spine and atrophy of supporting musculature may contribute as well (2)[A].
- Proper lifting technique and good posture
- Smoking cessation
- There is insufficient evidence to recommend for or against routine preventive measures in adults.
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Domino, Frank J., et al., editors. "Back Pain, Low." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117570/all/Back_Pain__Low.
Back Pain, Low. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117570/all/Back_Pain__Low. Accessed June 9, 2023.
Back Pain, Low. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117570/all/Back_Pain__Low
Back Pain, Low [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 09]. Available from: https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117570/all/Back_Pain__Low.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Back Pain, Low ID - 117570 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117570/all/Back_Pain__Low PB - Wolters Kluwer ET - 27 DB - 5-Minute Clinical Consult DP - Unbound Medicine ER -