Low back pain (LBP) causes more disability globally than any other condition. The point prevalence is 7.5% and the lifetime prevalence exceeds 80%. LBP accounts for over 4% of emergency department visits, making it one of the ten most common presenting complaints.
The primary purpose of the initial encounter is to evaluate whether the symptoms suggest a more serious underlying condition. The general prognosis of acute LBP is favorable, and most patients recover without sequelae. Recurrences are common, but most relapses are not disabling.
A smaller subset of the population may be incapacitated from chronic LBP, defined as symptoms persistent for >12 weeks. Several factors have been found to increase the risk of developing disabling LBP. These include maladaptive pain coping behaviors, nonorganic signs, functional impairment, poor general health status, and psychiatric comorbidities. The clinician should be aware of these risk factors when counseling and treating patients.
- Lumbar muscular strain/sprain
- Herniated nucleus pulposus
- Spinal stenosis
- Compression fracture
- Degenerative disk disease or facet arthropathy
- Cauda equina syndrome
- Spinal cord compression
- Spondylolysis and/or spondylolisthesis
- Vertebral discitis/osteomyelitis
- Inflammatory spondyloarthropathy
- Connective tissue disease
- Abdominal aortic aneurysm
- Renal colic
- Peptic ulcer disease
- Spinal epidural abscess
- Herpes zoster infection
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