The management of lower back pain

Lower back pain (LBP) is one of the most common musculoskeletal conditions, with an estimated 60-70% of the adult population experiencing a back problem at some point in their lives. It can have a significant social and occupational impact on a patient, and therefore is a major concern to both civilian and military populations. The impact of low back pain in the military setting, regardless of chronicity, can result in considerable restrictions on a patient's ability to perform his or her job. This may have important ramifications for deployability, medical category and, potentially, a patient's future career. This article will consider the diagnosis and classification of lower back pain (LBP) in the pre-shore, pre-hospital and hospital settings. It will detail management options including investigations, pain management and referral options; furthermore, the potential occupational implications of lower back pain will be detailed.