Nonoperative treatment of low back pain

Low back pain is a common problem with substantial social and economic issu es. Physicians continue to have difficulty managing this condition despite an increased awareness of its magnitude. In addition, there is a mispercept ion about the outcome of patients affected with low back pain; most continu e to suffer from pain. We present a nonoperative approach and review variou s diagnostic and treatment strategies with respect to both scientific and c linical merit, Although many treatment strategies have not been well proved in the scientific literature, thoughtful review of the available informati on provides a basis for the use of these treatment methods in the patient w ith refractory pain, This approach can be used in conjunction with existing information to assist clinicians in the management of patients with acute low back pain.