Assessment and management of acute low back pain

Acute low back pain is commonly treated by family physicians. In most cases , only conservative therapy is needed. However, the history and physical ex amination may eliciting warning signals that indicate the need for further work-up and treatment. These "red flags" include a history of trauma, fever , incontinence, unexplained weight loss, a cancer history, long-term steroi d use, parenteral drug abuse, and intense localized pain and an inability t o get into a comfortable position. Treatment usually consists of nonsteroid al anti-inflammatory agents or acetaminophen and a gradual return to usual activities. Surgery is reserved for use in patients with severe neurologic deficits and, possibly, those with severe symptoms that persist despite ade quate conservative treatment.