Principles of diagnostic - therapeutic proceedings in back pain

"Back pain" is a common cause of specialistic medical consultations. Diagnostics and treatment requires and individualized proceedings, but it's rules should be followed.
The principles, with consideration to national reality of medical care system, were formed due to initiative of Orthopaedics Department of Warsaw Medical University, on multidisciplinary meeting (called Back Pain School) in 1998, and precisely edited by Spondyloorthopaedics Section of PTOiTr (Polish Society of Orthopaedics and Traumatology of the Locomotor System).
The principles are in use in both orthopaedic departments, in Warsaw and in Poznan since the end of 1998. They assume the parallel diagnostic and therapeutic action in assessment of acute back pain syndromes. They involve the use of an aggressive pharmacotherapy with NSAIDs, myorelaxants, other methods of pain control (radicular, truncal and intrathecal blocks) and manual therapy. Just after a carefull clinical evaluation and decrease of pain, the conventional radiological diagnostics is required. It allows to classify correctly a clinical diagnosis and the treatment orientation. It also permits to reduce costs of the proceedings which usually, especially in other medical specialties, comprise an advanced imaging diagnostics including magnetic resonance and computed tomography.
The aim of this work is to remind a history of action and backgrounds, which lead to a system of diagnostic - therapeutic proceedings in back pain creation in our country.