Low Back Pain

Introduction
• 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
– Acute ( least than 6 weeks)
– Subacute ( 6 weeks to 3 months)
– Chronic (more than 3 months)
• Associated symptoms
– Localized/nonspecific “mechanical” LBP
– Back pain with lower extremity symptoms
– Systemic and visceral symptoms
• There isn't the specific cause for most patients with LBP. Most cases resolve in 4 to 6 weeks
• Rule out “red” flag symptoms are needed for immediate intervention
• System(s) affected: musculoskeletal, neurologic
• Synonym(s): lumbago, lumbar sprain/strain, low back syndrome.

Etiology and Pathophysiology
A clear etiology is not found in most patients. Age-related degenerative changes of the lumbosacral spine and atrophy of supporting musculature may contribute.

Risk Factors
• Age
• Activity (lifting, sudden twisting, bending)
• Obesity
• Sedentary lifestyle
• Physically strenuous work
• Psychosocial factors—anxiety, depression, stress
• Smoking

General Prevention
• Maintain normal weight
• Adequate physical fitness and activity
• Stress reduction
• Proper lifting technique and good posture
• Smoking cessation
• There isn't sufficient evidence to recommend for, or against routine preventive measures in adults.