Persistent Low Back Pain

A 49-year-old maintenance worker with a history of depression and previous reports of minor back pain is seen during four months of continuing low back pain. He has remained out of work for fear of worsening the injury. Magnetic resonance imaging two weeks after the onset of pain showed only mild de...

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Published inThe New England journal of medicine Vol. 352; no. 18; pp. 1891 - 1898
Main Author Carragee, Eugene J
Format Journal Article
LanguageEnglish
Published Boston, MA Massachusetts Medical Society 05.05.2005
Subjects
Online AccessGet full text
ISSN0028-4793
1533-4406
DOI10.1056/NEJMcp042054

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Abstract A 49-year-old maintenance worker with a history of depression and previous reports of minor back pain is seen during four months of continuing low back pain. He has remained out of work for fear of worsening the injury. Magnetic resonance imaging two weeks after the onset of pain showed only mild degenerative changes in the lumbar region without spinal stenosis or disk collapse or extrusion. How should this patient be evaluated and treated? A 49-year-old maintenance worker with a history of depression is seen during four months of continuing low back pain. Magnetic resonance imaging showed only mild degenerative changes in the lumbar region. Foreword This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations. Stage A 49-year-old maintenance worker with a history of depression and previous reports of minor back pain is seen after four months of continuing low back pain. He has remained out of work for fear of worsening the injury. Magnetic resonance imaging (MRI) two weeks after the onset of pain showed only mild degenerative changes in the lumbar region without spinal stenosis or disk collapse or extrusion. How should this patient be evaluated and treated? The Clinical Problem Low back pain without sciatica, stenosis, or severe spinal deformity is common, with a reported point prevalence as high as 33 percent . . .
AbstractList A 49-year-old maintenance worker with a history of depression and previous reports of minor back pain is seen during four months of continuing low back pain. He has remained out of work for fear of worsening the injury. Magnetic resonance imaging two weeks after the onset of pain showed only mild degenerative changes in the lumbar region without spinal stenosis or disk collapse or extrusion. How should this patient be evaluated and treated?
A 49-year-old maintenance worker with a history of depression and previous reports of minor back pain is seen during four months of continuing low back pain. He has remained out of work for fear of worsening the injury. Magnetic resonance imaging two weeks after the onset of pain showed only mild degenerative changes in the lumbar region without spinal stenosis or disk collapse or extrusion. How should this patient be evaluated and treated? A 49-year-old maintenance worker with a history of depression is seen during four months of continuing low back pain. Magnetic resonance imaging showed only mild degenerative changes in the lumbar region. Foreword This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations. Stage A 49-year-old maintenance worker with a history of depression and previous reports of minor back pain is seen after four months of continuing low back pain. He has remained out of work for fear of worsening the injury. Magnetic resonance imaging (MRI) two weeks after the onset of pain showed only mild degenerative changes in the lumbar region without spinal stenosis or disk collapse or extrusion. How should this patient be evaluated and treated? The Clinical Problem Low back pain without sciatica, stenosis, or severe spinal deformity is common, with a reported point prevalence as high as 33 percent . . .
Author Carragee, Eugene J
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Keywords Medicine
Pain
Lumbar spine
Low back pain
Diseases of the osteoarticular system
Rachialgia
Spine disease
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Snippet A 49-year-old maintenance worker with a history of depression and previous reports of minor back pain is seen during four months of continuing low back pain....
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SubjectTerms Back pain
Biological and medical sciences
Diseases of the osteoarticular system
Diseases of the spine
Ergonomics
General aspects
Infections
Medical sciences
NMR
Nuclear magnetic resonance
Risk factors
Title Persistent Low Back Pain
URI http://dx.doi.org/10.1056/NEJMcp042054
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