Acute low back pain is one of the most common health problems in family medicine. This pain is experienced at least once in the life of 60–80 % of people.
The aim is to study the European (Croatian and Slovenian) experience of the diagnostic approach to the management of a patient with the problem of acute low back pain in the practice of a family doctor.
Acute low back pain is the reason for frequent visits to the family doctor. Most patients are diagnosed with uncomplicated low back pain, which does not require additional diagnostic tests, and a course of treatment and a short hospital stay (up to two weeks) is prescribed by a family doctor.
Back pain is not a definitive diagnosis. This may be a reason to visit or as a working syndrome diagnosis. To determine the cause of pain, it is necessary to determine the source of pain in order to select the appropriate treatment for the patient. To identify the cause it is necessary to collect history and conduct clinical examinations for the following factors: uncomplicated low back pain, radicular back pain, severe pathology of the lumbosacral region, pain from related structures, psychosocial factors (somatization, exacerbation). A small number of patients with acute low back pain develop chronic low back pain, which is established as a diagnosis after clinical symptoms persist for six months. It is important to immediately diagnose patients who may initially develop chronic low back pain, which requires referral for additional diagnostic examination, physical therapy, and to assess for temporary or permanent disability.
Carrying out the diagnostic process according to the above algorithm allows to determine the causative factor of acute low back pain, which will prescribe an effective and rational scheme of such a patient to correct the clinical condition, relieve pain and prevent chronic low back pain.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.
Babinets LS, Halabitska IM. Chronic inflammatory process and bone tissue changes in patients with osteoarthritis and exocrine pancreatic insufficiency. Lekarsky Obzor. 2020;69(1):7-10.
DeFrate LE, Kim-Wang SY, Englander ZA, McNulty AL. Osteoarthritis year in review 2018: mechanics. Osteoarthritis and Cartilag. 2019;27(3):392-400. Available from: https://doi.org/10.1016/j.joca.2018.12.011
Žorž G. Akutna bolečina v križu (Acute Low Back Pain). U: Švab I, Rotar-Pavlič D. Družinska medicina (Family Medicine). − Ljubljana: Združenje zdravnikov družinske medicine (Association of Family Physicians), 2018, 17-24.
Koes BW, van Tulder M, Lin CW, Macedo LG, McAuley J, Maher C. An updated overview of clinical guidelines for the management of non-specific lowback pain in primary care. Eur Spine J. 2010;19:2075-94.
Williams CM, Maher CG, Hancock MJ, McAuley JH, McLachlan AJ, Britt et al. Lowback pain and best practice care: A survey of general practice physicians. Arch Intern Med. 2018;170:271-7.
Coole C, Watson PJ, Drummond A. Work problems due to lowback pain: what do GPs do? A questionnaire survey. Fam Pract. 2010;27:31-7.
Chou R, Qaseem A, Owens DK, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Diagnostic imaging for lowback pain: advice for high-value health care from the American College of Physicians. Ann Intern Med. 2017;154:181-9.
HZZO (Croatian Health Insurance Fund). Izvješće o bolovanju na teret sredstava Hrvatskog zavoda za zdravstveno osiguranje prema međunarodnoj klasifikaciji bolesti za 2018. godinu (Report on Sick-Leave Paid by Croatian Health Insurance Fund in 2018, According to International Classification of Diseases). Available at: http://www.hzzo-net.hr
Bach SM, Holten KB. Guideline update: what’s the best approach to acute lowback pain? J Fam Pract. 2019;58:E1.
National Institute for Health and Clinical Excellence. Lowback pain. Available at: http://www.nice.org.uk