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Low Back Pain 

Low Back Pain
Chapter:
Low Back Pain
Author(s):

Steven P. Cohen

, Artemus Flagg

, and Julie H. Y. Huang

DOI:
10.1093/med/9780199859436.003.0008
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date: 17 April 2021

Low back pain is the leading cause of disability in non-elderly individuals throughout the world. Over 50% of individuals will experience a significant back pain episode in their life, with psychosocial factors such as depression and poor job satisfaction being the strongest predictors of developing chronic pain. The most important distinction to make when evaluating the patient with chronic back pain is whether the pain is neuropathic or mechanical, as this categorization affects treatment decisions at every level. For many types of back pain (e.g. facet joint pain), blocks are the reference standard for diagnosis. Procedural interventions such as epidural steroid injections (up to 6 months) and radiofrequency denervation (up to 1 year) may provide significant intermediate-term relief for in well-selected patients, while surgery should be reserved for more refractory cases.

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