Acute low back pain: assessment and management.

BACKGROUND Back pain is a common presenting problem in Australian general practice. Serious causes, however, are rare. Tumours, infections and fractures account for less than 1% of cases and can usually can be recognised or excluded by taking a careful history. Patients should expect a good outcome. OBJECTIVE This article summarises the management of acute low back pain and sets out the key points in history taking including alerting factors for serious disorders, and psychosocial factors that enable a rational management plan. DISCUSSION A specific cause of pain need not be established for appropriate management to be instituted, with the active engagement of the patient as partner. Although no pattern of pain is diagnostic, a sudden onset of unremitting pain should be regarded as a 'red flag' to a serious underlying disorder. In accordance with evidence based principles, clinicians need to take into account previous experience, personal preferences, and cultural factors when recommending therapy for individual patients.