Low back pain, part 1 - Primary care work-up of acute and chronic symptoms

Low back pain may present as acute pain or as an acute exacerbation of a ch ronic pain problem. Acute low back pain Is self-limited, with 90% of affect ed Individuals recovering within 3 weeks to 3 months. Pain duration of more than 4 weeks warrants a more complete workup, Including ruling out maligna ncy. Pain duration of more than 6 months defines chronic pain, which Is fre quently associated with affective and behavioral components. When taking th e history, determine pain Intensity, location, pattern of radiation, onset, and duration. A gentle physical exam may help locate the source of pain th rough palpation and maneuvers, such as the straight leg raise test. Imaging Is recommended for patients with a clinical finding that raises suspicion of spinal malignancy.