Low back pain.

A. Delitto, S. George, L. V. van Dillen, J. Whitman, G. Sowa, P. Shekelle, Thomas R. Denninger, J. Godges • 1/1/1970

Abstract

Current literature does not support a definitive cause for initial episodes of low back pain.Risk factors are multi-factorial, population specific, and only weakly associated with the development of low back pain.(Recommendation based on moderate evidence.) Clinical CourseThe clinical course of low back pain can be described as acute, sub acute, transient, recurrent, or chronic.Given the high prevalence of recurrent and chronic low back pain and the associated costs, clinicians should place high priority on interventions that prevent (1) recurrences and (2) the transition to chronic low back pain.(Recommendation based on theoretical/foundational evidence.) Diagnosis/ClassificationLow back pain, without symptoms or signs of serious medical or psychological conditions, associated with 1) mobility impairment in the thoracic, lumbar, or sacroiliac regions, 2) referred or radiating pain into a lower extremity, and 3) generalized pain are useful clinical findings for classifying a patient with low back pain into the following International Statistical Classification of Diseases and Related Health Problems (ICD) categories: low back pain, lumbago, lumbosacral segmental/somatic dysfunction, low back strain, spinal instabilities, flatback syndrome, lumbago due to displacement of intervertebral disc, lumbago with sciatica, and the associated International Classification of Functioning, Disability, and Health (ICF) impairment-based category of low back pain (b28013 Pain in back, b28018 Pain in body part, specified as pain in buttock, groin, and thigh) and the following, corresponding impairments of body function: * These recommendations and clinical practice guidelines are based on the scientific literature accepted for

Citations: 257