Nonspecific back pain: approach and management

Back pain is a debilitating condition that affects many people. The work environment, the overall health status and one’s psychosocial state may predispose an individual to back pain. Back pain may be the result of osteoporotic or traumatic bone fractures, degenerative joint disease, neurological compromise, inflammation, infection or muscle spasms. Nonsteroidal anti-inflammatory drugs are the first-line medication for back pain, but opioids and muscle relaxants are also effective. Surgical intervention is rarely indicated for patients with back pain alone, but may be helpful for patients with leg pain secondary to spinal stenosis and/or degenerative spondylolisthesis, who have failed conservative management.