Low back pain, part 2 - Guide to conservative, medical, and procedural therapies

For patients without a specific diagnosis, treatment of low back pain begin s with strategies to avoid re-Injury and exacerbation. Most patients benefi t from some form of medical therapy, guided by the three-step World Health Organization analgesic ladder. Oploid therapy Is appropriate when needed fo r low back pain, especially In the acute period. Adjuvant medication (eg, a n anticonvulsant or antidepressant) may help reduce or eliminate the need f or oploid therapy. Side effects are common with oploid medications, althoug h many resolve with time. Patient education In exercise, back protection, n utrition, and sexual concerns Is an Important component of treatment. Some patients may benefit from referral to a pain center for multidisciplinary m anagement. Those with a structural or mechanical cause of pain may do well with surgery.