Can you name someone who hasn’t complained of low back pain? It is the most common cause of disability in people younger than 45 years of age—so it isn’t only the elderly who suffer.

Ninety percent (90%) of the time, low back pain is caused by somatic dysfunction or due to poor posture:

• Dull and achy

• Having diffuse or non-specific muscle tenderness

• Worsening with movement

• Being relieved with rest or laying down

• Remaining localized (does not move or radiate)

•  Without paresthesias (“pins and needles”) or weakness

Ten percent (10%) of the time, low back pain can really be caused by something else:

•  Muscle spasms

• Ligament sprains and strains

• Inflammation from infection or rheumatism

• Metabolic disorders

• Referred pain from organ dysfunction or disease

• Herniated disc

• Bone abnormalities

• Vertebral stenosis

• Lesions within the spinal cord

Did you know that 90 percent (90%) of all episodes of low back pain resolve within six weeks?

That is why the most recent recommendations by the World Health Organization and The Department of Defense have revised their recommendations.

THE BOTTOM LINE

Providers have been taking good notes and discovering that the best way to treat low back pain isn’t what they thought was necessary or appropriate. Of course, LOW BACK PAIN isn’t a clear-cut definition, but this is what is out there for Providers to consider.

• Without specific signs and symptoms that suggest a serious underlying problem, further testing and imaging like XRAYS or MRI is not helpful in the first four weeks.

• If managed appropriately, low back pain should not cause long-term disability and suffering.

• If pain persists or there are “red flags”, further workup is likely needed:

• Recent bowel or bladder dysfunction

• Traumatic injury

• Steroid use

• Osteoporosis

• History of cancer

• Diabetes mellitus

• Insidious onset

• No relief at bedtime or worsens when laying down

• Fever, chills, muscle pains, sweats

• History of infection(s)

• IV drug use

• HIV or immunocompromised

• Autoimmune disease

• Prior surgery

What is most important when someone has back pain is to offer the provider the most information as possible regarding why, when, how, what and where the pain started.

• What have you done or which medications lessen the pain?

•  What positions, weather, and activities make the pain worse?

• Have lost or gained weight recently?

• What type of work, hobbies or athletic activities do you pursue?

• Any family or personal medical history of arthritis, autoimmune or connective tissue disease?

• Did the pain come on suddenly or gradually, and has it has changed over time?

• Is the pain so terrible that it wakes you up at night?