Low Back Pain


Red Flags

  • Requires early imaging
    • History Findings
      • Cancer metastatic to bone (breast, lung, thyroid, renal, • prostate) •
      • Urinary or fecal incontinence 
      • Urinary retention
      • Progressive lower extremity motor or sensory loss
      • Significant trauma related to age
      • Severe pain and lumbar spine surgery in the prior 12 months

    • Exam Findings
      • Major motor weakness or sensory loss
      • Saddle anesthesia
      • Loss of anal sphincter tone

Acute Low Back Pain Treatment

Chronic Low Back Pain Treatment

  • *Beneficial
    • NSAID, tramadol, duloxetine (Mindfulness-based stress reduction – know this one )
    • Acupuncture
    • Exercise therapy (walking prgm = PT)
    • Yoga
    • Massage
    • Superficial heat*
    • Physical therapy
    • Intensive multidisciplinary treatment program (B) Behavioral therapy (B)

  • Likely Beneficial
    • Skeletal muscle relaxants
    • PT directed home exercise program Prolotherapy
    • Antidepressants (B)Back school (B)
    • S-adenosyl-L-methionine Harpagophytum procumbens (devil’s claw) Salix alba (white willow bark)