[Back pain in the primary care setting : Non-specific back pain]

A systematic survey of the symptoms of back pain in terms of the triggering event and onset, nature of the pain and the extent to which pain dynamics can be influenced (lying or standing, under stress, nocturnal pain, localized percussion tenderness, B symptoms, etc.), as well as a structured clinical examination (segment height, radiance, projection, reflex status, sensitivity, and motor function), allows an initial and therefore orienting classification of back pain as non-specific or specific. Thus, in the primary care setting, many patients can be treated extremely effectively and economically from a cost perspective. The more precise the initial findings are, the more effective the measures taken are in general. In addition to the fastest possible pain relief, it is important to prevent the disease taking an unfavorable course and to avoid chronicity. In addition to non-pharmacological measures (initial rest and starting home exercises early on, promoting everyday mobility, physiotherapy, manual therapy, etc.), a wide range of pharmacological treatment alternatives is available. In the further course of treatment, it may be necessary to consult medical specialists in the fields of radiology, orthopedics, neurology, neurosurgery, rheumatology, psychotherapy, and psychiatry, among others. Treatment is managed by the primary care provider, who should also receive and re-evaluate all findings during the course of the disease.