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Low Back Pain Guidelines for Care

Jun 12, 2015
  1. Low back pain affects 80% of people at some point in their lifetime.
  2. Low back pain is a symptom, not a diagnosis. The cause is not well understood.
  3. The severity of the pain does not necessarily correlate with the severity of the problem.
  4. Acute low back pain will spontaneously resolve in 80% of patients in 4 to 6 weeks. Therefore, there is no absolute need to initially try to make a diagnosis. If the symptoms persist and are problematic a diagnosis should be sought.
  5. An MRI/Scan is the best roadmap to confirm the etiology of the pain.
  6. When an exact diagnosis can’t be made despite specialist investigation, the emphasis should be placed on symptomatic relief with the door open to re-evaluation.
  7. The goal of physical therapy, the mainstay of conservative care, is to alleviate symptoms and to prevent recurrence (85% of patients with low back pain experience recurrent symptoms) by developing posture coordination to protect back.
  8. Shooting pain or numbness down the leg is a sign of sciatica and should be evaluated by a spine specialist.
  9. Steroid injections can temporarily decrease the inflammation from sciatica, but do not treat nerve root compression.
  10. Spinal stenosis, or narrowing of the spinal canal in the older population, can lead to pain, numbness and heaviness in the legs and decrease walking ability. These symptoms are often relieved by sitting down.
  11. If conservative measures fail, minor surgery relieves nerve root compression down the leg.
  12. Spinal fusion treats instability and low back pain. Minimally invasive technique decreases the morbidity of the procedure and allows early return to normal function.