Low back pain: Diagnosis and treatment options

Abstract

Diseases of the lumbar spine, manifested as low back pain (LBP), are presented by pain in the lumbosacral region, with possible propagation along one or both legs, where signs of motor and/or sensory disturbances may also be present. According to its character, features, mode of occurrence, and duration, the pain can be acute (non-specific LBP), subacute, chronic, neuropathic, or radicular, and can be accompanied by serious spinal pathology, with a large neurological deficit. The importance of this problem is indicated by the fact that LBP is the second most frequent reason for visits to the doctor, but also the leading cause of work incapacity. The paper gives a brief overview of this problem from the aspects of epidemiology, etiology, pathophysiology, and clinical presentation, with a focus on diagnostic and treatment options. The importance of the clinical examination is particularly emphasized, with an emphasis on the importance of noticing warning symptoms ("red flags") that require immediate assessment and treatment. Additional diagnostic modalities, including radiography, magnetic resonance imaging, computed tomography, electromyoneurography and (EMNG), are useful in discovering the cause of low back pain and making treatment decisions. The treatment of lumbar syndrome requires a multispecialty team and a multimodal approach, including non-pharmacological and pharmacological therapy, and in some, the most severe cases, surgical treatment. A multidisciplinary approach involves the engagement of various medical specialties and subspecialties, including specialists in physical medicine and rehabilitation, neurology, pain medicine, neurosurgery, orthopedics, anesthesiology, and others, as needed.