Manage back pain with activity and analgesia

A recent article in the British Medical Journal proposes that non-medical staff should take over the treatment of back pain.1 It suggests that GPs feel ill equipped to manage the problem. However, in Australia, Therapeutic Guidelines: Rheumatology provides helpful advice.

Most people will have acute low back pain at some time in their lives. In the majority of cases the symptoms will improve rapidly even without specific treatment. The management of the patient aims to reduce pain, maintain function, minimise time off work and prevent the pain becoming chronic. Explanation and reassurance are important, and the patient’s concerns should be explored.

‘Red flag’ symptoms should be investigated, but imaging is not indicated for acute non-specific back pain. Radiological findings are usually poorly correlated with the patient’s symptoms.

Patients should be advised to keep moving. Staying active increases the rate of recovery

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