Conservative management of low back pain

Diagnosis and treatment of low back pain may well have seen more progress in the past five years than in the previous 50. Specific diagnoses can be made by history and physical examination and can often be objectively documented by modern high-resolution computed tomographic scanning of the lumbar spine. A number of innovative conservative treatment modalities show great promise in decreasing the need for surgical intervention. Surgery is indicated only when appropriate conservative measures have failed. However, the greatest changes are yet to come. These will relate to prevention of low back pain through professional instruction of patients regarding activities, exercises, and life-style beneficial to the lumbar spine.