Management of Low Back Pain

  • Otávio Turolo da Silva
  • Andrei Fernandes Joaquim
  • Alpesh A. Patel


Low back pain is one of the main causes of patients’ disability, work absenteeism, and emergency department visits. Low back pain is defined as a pain between the rib cage and the buttocks that may or may not radiate into the legs. The prevalence of low back pain is influenced by socioeconomic factors, having a higher incidence in developed countries, reaching about 30% of prevalence in these populations and about 18.2% in poor countries. Identification of “red flags” are useful for differentiating primary and secondary (due to fracture, cancer, infection, etc.) low back pain. Acute low back pain has generally a benign and transient course. Imaging usually is not necessary for acute low back pain without the presence of “red flags.” Complete rest is not routinely recommended initially, and patient should return to normal activities as soon as possible. For nonspecific low back pain, medical treatment with common analgesics and NSAIDs is sufficient to treat the pain in the majority of the cases. Opioid medications should be avoided in the treatment of low back pain. Emergency doctors must be alert to signs and symptoms of secondary diseases and further investigation.


Low back pain Acute Chronic Treatment 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Otávio Turolo da Silva
    • 1
  • Andrei Fernandes Joaquim
    • 1
  • Alpesh A. Patel
    • 2
  1. 1.Department of Neurology, Neurosurgery DivisionUniversity of Campinas (UNICAMP)CampinasBrazil
  2. 2.Department of Orthopaedic SurgeryNorthwestern University Feinberg School of MedicineChicagoUSA

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