Neurológia pre prax 3/2010

Some causes of low back pain and their treatment

Low back pain (LBP) is defined as pain, muscle tension or stiffness localized below the low costal margin and above the gluteal folds, with or without leg pain. LBP is currently a tremendous medical and socio-economic problem and it has a lifetime prevalence of 60–85 %. The article is focused on non-specific low back pain. There is a syndrome, which mostly is not in the preference of neurologists. The basic division of LBP is to acute and chronic, but more important division is to specific cause and just non-specific one (without clear cause – up to 90 % cases). But now, it seems, the most important is a division into a diagnostic triage (very serious illness, radicular pain, simple LBP). Numerous randomized controlled trials and systematic reviews show strong evidence for advice to stay active and fitness programmes. Treatment targets are reduction of pain, bettter activity and participation, including disability prevention as well as maintenance of work capacity. Maintenance of activity, simple analgesics and non-steroidal anti-inflammatory drugs are effective in treatment of acute LBP. Exercise therapy (aerobic fitness), behavioural therapy and multidisciplinary pain treatment programmes are effective in treatment of chronic LBP.

Keywords: low back pain, non-specific low back pain, treatment possibilities, multidisciplinary approach.