Back Pain, Low
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- Low back pain (LBP) is extremely common and includes a wide range of symptoms involving the lumbosacral spine and pelvic girdle.
- Characterized by duration or associated symptoms
- Duration (1)[A]
- Acute (<6 weeks)
- Subacute (>6 weeks but <3 months)
- Chronic (>3 months)
- Associated symptoms (1)[A]
- 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% (2)
- 1-year incidence for any episode: 1.5%–36% (2)
- A very common primary care complaint (1)
Etiology and Pathophysiology
LBP can be commonly due to muscle spasm/tension. Estimated 39% of chronic LBP due to disk degeneration. 30% estimated to be from facet joint syndrome. Other possibilities include sacroiliac injuries/degeneration and spinal stenosis. Age-related degenerative changes of the lumbosacral spine and atrophy of supporting musculature may contribute as well (2)[A].