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[1] [2] Waddell's signs may indicate non-organic or psychological component to chronic low back pain. Historically they have also been used to detect malingering in patients with back pain. While testing takes less than one minute, [2] it has been described as time-consuming and alternatives have been proposed. [3]
Spinal manipulation appears to provide similar effects to other recommended treatments for chronic low back pain. [57] There is no evidence it is more effective than other therapies or sham, or as an adjunct to other treatments, for acute low back pain [58] "Back school" is an intervention that consists of both education and physical exercises.
Low back pain or lumbago is a common disorder involving the muscles, nerves, and bones of the back, in between the lower edge of the ribs and the lower fold of the buttocks. Pain can vary from a dull constant ache to a sudden sharp feeling. [ 4 ]
Williams, Paul C. (1974), Low Back and Neck Pain: Causes and Conservative Treatment, Ed 3; Springfield:Charles C Thomas; 78 pages. Williams P, (1955), "Examination and conservative treatment for disc lesions of the lower spine", Clinical Orthopaedics and Related Research 528-40.
Clinical guidelines for prescribing opioids for chronic pain have been issued by the American Pain Society and the American Academy of Pain Medicine. Included in these guidelines is the importance of assessing the patient for the risk of substance abuse, misuse, or addiction.
Low back pain accounts for 17% of all physician visits of people aged 65 and older. [37] From this population, a large portion of radicular pain stems not from disk pathology, but from lumbar spinal stenosis. [37] According to Kalff et al., 21% of people over the age of 60 have lumbar spinal stenosis, as confirmed by radiological screening. [38]
For acute low back pain, low quality evidence has suggested no difference between real and sham spine manipulation, [46] and moderate quality evidence has suggested no difference between spine manipulation and other commonly used treatments, such as medication and physical therapy. [46] [47] [48]
Injuries and pain in the musculoskeletal system caused by acute traumatic events like a car accident or fall are not considered musculoskeletal disorders. [4] MSDs can affect many different parts of the body including upper and lower back, neck, shoulders and extremities (arms, legs, feet, and hands). [5]