Rational evaluation and management of the patient with spinal pain

Abstract

Low back pain is a common adult complaint throughout the developed world. The majority of acute low back pain episodes will relent spontaneously. Evaluation is not needed immediately if there are no red flags. A small number of patients with acute disk herniation will require surgery based upon severity of pain and real or impending neurological deficits. Many can be relieved of radicular pain by perineural steroid injection and/or a short course of oral steroids. Rapid mobilization and return to function are helpful.