Management of Low Back Pain Therapies
Summary
The management of low back pain encompasses a spectrum of interventions tailored to the phase and severity of symptoms. First-line care for acute presentations emphasises patient education, self-management and early mobilisation, complemented by supervised exercise programmes and manual therapies to restore function and prevent chronicity. For subacute and chronic cases, multidisciplinary approaches integrate cognitive and behavioural strategies, physiotherapy and targeted pharmacotherapy. Non-steroidal anti-inflammatory drugs (NSAIDs) remain the most widely recommended analgesics, with skeletal muscle relaxants and acetaminophen as adjuncts. Opioid therapy is reserved for selected patients with refractory or neuropathic pain components, administered under close monitoring to minimise dependency. Interventional techniques—including epidural steroid injections and radiofrequency ablation—are considered when conservative measures prove insufficient. Emerging therapies focus on precision-based regimens that combine physical, pharmacological and psychological modalities, aiming to reduce disability, improve quality of life and curb overuse of high-risk medications.
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Management of Low Back Pain Therapies publication trend
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Technical terms
Non-specific low back pain: Pain in the lumbar region without a clearly identifiable pathoanatomical cause.
Subacute: Symptom duration of six to twelve weeks, intermediate between acute and chronic phases.
Network meta-analysis: A statistical technique that allows simultaneous comparison of multiple treatments by integrating direct and indirect evidence from clinical trials.
Non-steroidal anti-inflammatory drugs (NSAIDs): A class of medications that relieve pain and reduce inflammation by inhibiting cyclooxygenase enzymes.
Visual analogue scale (VAS): A patient-reported tool for quantifying pain intensity, typically ranging from 0 (no pain) to 100 mm (worst imaginable pain).
References
- Effectiveness of treatments for acute and subacute mechanical non-specific low back pain: a systematic review with network meta-analysis. British Journal of Sports Medicine (2021).
- Systematic review of guideline-recommended medications prescribed for treatment of low back pain. Chiropractic & Manual Therapies (2022).
- Inhalation of Pelargonium graveolens Essential Oil Alleviates Pain and Related Anxiety and Stress in Patients with Lumbar Spinal Stenosis and Moderate to Severe Pain. Pharmaceuticals (2023).
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