Back Pain: background, aetiology, diagnosis and treatment

Abstract

Key topics for doctors in their foundation years covering the aetiology, diagnosis and management of back pain are reviewed. Back pain is a common cause of pain and disability particularly in adults of working age. It is also a common cause for attendance at General Practitioners and a frequent reason given by employees for days of work. NICE estimate the cost associated with treating all types of back pain is more than £1000 million a year. A complex mixture of conditions can present with the symptom of back pain. At their most trivial they require only minimal treatment but at their most serious urgent investigation and surgical intervention are required to prevent severe disability. Most medical practitioners will encounter patients with back pain and will be required to diagnose common causes, manage symptoms and refer as appropriate. Balancing the need to detect treatable conditions and not miss serious spinal pathology against the complications and cost of over investigation requires a sound knowledge of how conditions present and good clinical skills. Some of the causes of serous spinal pathology are reviewed as well as some of the surgically treatable conditions. As some patients may choose to consult complementary practitioners a short review of different therapies that are used to treat back pain, and the available evidence for them is included.