Diagnostic Approaches to a Patient with the Problem of Acute Low Back Pain at the Family Doctor’s Practice (According the Experience of Croatia and Slovenia)

Abstract

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.