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Chronic low back pain

D G Borenstein1

  • 1Department of Medicine, George Washington University Medical Center, Washington, DC, USA.

Rheumatic Diseases Clinics of North America
|August 1, 1996
PubMed
Summary
This summary is machine-generated.

Most low back pain resolves within 12 weeks, often due to mechanical causes like muscle strain. Chronic back pain, however, stems from diverse mechanical and non-mechanical disorders requiring specific diagnosis and targeted therapy for improved function.

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Area of Science:

  • Orthopedics
  • Radiology
  • Rheumatology

Background:

  • Low back pain is common, with most cases resolving within 12 weeks.
  • Acute episodes are typically linked to mechanical issues like muscle strain or disc herniation.
  • A subset of patients experiences chronic low back pain exceeding 12 weeks.

Purpose of the Study:

  • To review the causes and diagnostic approaches for chronic low back pain.
  • To highlight the role of various imaging modalities in evaluating chronic low back pain.
  • To discuss the management principles for chronic low back pain.

Main Methods:

  • Review of literature on chronic low back pain etiology and diagnosis.
  • Discussion of diagnostic imaging techniques including plain roentgenograms, CT scans, and MR imaging.

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  • Overview of therapeutic strategies tailored to specific underlying causes.

    • Main Results:

    • Chronic low back pain arises from diverse mechanical (e.g., osteoarthritis, spinal stenosis) and non-mechanical disorders (e.g., infections, neoplasms, rheumatologic conditions).
    • Clinical symptoms guide diagnostic evaluation, with imaging playing a crucial role: plain X-rays for stenosis/tumors/osteoporosis, CT for bony/vascular detail, and MRI for malignancy extent/endometriosis.
    • Therapies are disease-specific, aiming to decrease pain and improve function, though cures are not always possible.

    Conclusions:

    • Accurate diagnosis of the underlying cause is essential for effective management of chronic low back pain.
    • Imaging modalities are vital tools for identifying specific pathologies contributing to chronic low back pain.
    • While not always curable, targeted therapies can significantly improve quality of life for patients with chronic low back pain.