Abstract
About 60–80% of patients visiting a physician have at some stage in their lives suffered from low back pain. The annual incidence in adults aged 35–55 years in developed countries is up to 45%.1 The differential diagnosis is broad and includes muscular strain, primary spine disease like disc herniation or degenerative arthritis, systemic diseases like metastatic cancer and regional diseases like aortic aneurisms. In the majority of cases, a specific diagnosis cannot be made. Most patients will improve in 1–4 weeks and will only need treatment for the acute symptoms after the initial history and physical examination. If, however, the pain recurs or worsens, the patient must be thoroughly examined and a specific diagnosis can become a challenge.
Highlights
About 60–80% of patients visiting a physician have at some stage in their lives suffered from low back pain
Most patients will improve in 1–4 weeks and will only need treatment for the acute symptoms after the initial history and physical examination
There are multiple causes of lower back pain and the physician will always attempt to get to the correct cause in order to ensure that the most effective treatment is recommended
Summary
About 60–80% of patients visiting a physician have at some stage in their lives suffered from low back pain. The pain recurs or worsens, the patient must be thoroughly examined and a specific diagnosis can become a challenge. This will ensure that serious causes of lower back pain are not overseen. 1. The non-opioid analgesics Paracetamol (acetaminophen) is the most commonly used and prescribed analgesic for lower back pain. Paracetamol has a central anti-nociceptive effect through selective inhibition of prostaglandin H2 synthetase. Aspirin is the oldest and most well-known and widely used analgesic It has analgesic, antipyretic and anti-inflammatory actions and causes respiratory stimulation. There are two iso-forms – COX-1 and 2, which led to the sub-group of COX-2 selective inhibitors Their main actions are analgesic, anti-inflammatory, antipyretic and antiplatelet (prevent thromboxane production).
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