Persistent Lower Back Pain

Introduction

Low back pain is one of the most common complaints prompting medical evaluation.¹ Up to 85% of isolated low back pain has no obvious etiology,² and often more than one etiology is possible. Furthermore, a detectable anatomical or physiological abnormality may correlate poorly with symptoms.³ Most patients with acute low back pain improve within 4 to 6 weeks with conservative therapy, but if recovery fails to occur, a review of the history and physical re-examination may be appropriate. Although most episodes of low back pain are self-limited, 5% to 10% of patients will develop persistent low back pain, with symptoms lasting three or more months.⁴ Persistent low back pain is often disabling and interferes with work, ADLs, and social relationships. Treatment goals are to minimize disability, pain and inappropriate medication use, while achieving optimal restoration of normal function.