Management of back pain: Step One Measures
Let us continue to develop our algorithm for management of back pain. We have seen so
far that back pain can be classified into three categories based on the presence of:- Red flag symptoms and signs with a pathological spinal disorder indicating
urgent need for specialist attention and possibly immediate surgery - Pathological spinal disorder but without red flag symptoms and signs indicating
that the problem is not serious enough to warrant immediate specialist attention
and can be managed with conservative treatments.^
- No detectable pathological cause on clinical examination or investigations.
If you have red flags you may need appropriate surgical treatment to prevent permanent
damage to the spinal nerves or cord. For those conditions not having a red flag or where
no pathological cause has been found, conservative (non-surgical) measures need to be
considered for a period of two weeks in order to relieve the symptoms. These initial
treatments can be called as Step One measures.BACK PAIN
(^)
PATHOLOGICAL CAUSE
NO PATHOLOGICAL
RED FLAGS^
BUT NO RED FLAG^ CAUSE^
APPROPRIATE SURGICAL (^) STEP ONE MEASURES
TREATMENT (^) FOR TWO WEEKS
(^)