Low Back Disorders

Abstract Low back pain has become a costly burden to society. It is currently the leading cause of disability worldwide. It is extremely common and affects all age groups throughout the world. Despite the steep rise in cost in the diagnosis and treatment of low back pain, outcomes have gotten worse, with more patients disabled than ever before. The physiatric approach to low back pain could reverse some of these worldwide trends. There are some serious causes of back pain in which a clear pathology can be identified, but for the vast majority of patients with low back pain, a specific cause cannot be found. Most people with new back pain recover quickly, but for a few, pain becomes persistent and costly. This chapter outlines the anatomy and biomechanics of the lumbar spine and our current understanding of the physiology of low back pain. Then, the clinical evaluation and treatment of various etiologies of low back pain and leg pain caused by lumbar spine disease are discussed. Information about how to recognize serious causes of low back pain so that they can be diagnosed early is covered. The evidence for various treatments of low back pain, and benefits and risks of treatment are thoroughly described so that physicians can protect patients from unproven or harmful approaches to management and deliver patient-centered care that focuses on self-management and healthy lifestyles. An overview of the treatment of low back pain in special populations, such as during pregnancy and back pain in children, is also covered.