Back Pain, Low
- Low back pain (LBP) is extremely common and is characterized by duration or associated symptoms.
- Acute (<6 weeks)
- Subacute (>6 weeks but <3 months)
- Chronic (>3 months)
- Associated symptoms
- 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%; 1-year incidence for any episode: 1.5–3.6%
- Lifetime prevalence: 84%
- Predominant sex: male = female
- Highest incidence in ages 20 to 29 years; prevalence increases with age until 65 years and then declines.
Etiology and Pathophysiology
- LBP can be commonly due to muscle spasm/tension.
- ~39% of chronic LBP due to disk degeneration, ~30% from facet joint syndrome. Other possibilities include sacroiliac injuries/degeneration and spinal stenosis.
- Activity (lifting, sudden twisting, bending)
- Sedentary lifestyle
- Physically strenuous work
- Psychosocial factors—anxiety, depression, stress
- Genetic factors
- Heavy operating equipment
- Poor flexibility
- Maintain normal weight.
- Adequate physical fitness and activity
- Stress reduction
- Proper lifting technique and good posture
- Smoking cessation
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