Back pain is very common; it has a point prevalence of 25% and is the third most common reason for consultation in Australian general practice. A thorough history and examination can identify the minority of patients who require urgent neuroimaging or other targeted investigations. Careful correlation of clinical and radiological findings is required when abnormal neurological findings are detected. Radiological investigations may detect abnormalities at multiple levels but cannot confirm which level is primarily responsible for a patient's symptoms. A trial of conservative treatment is appropriate, even in cases of radiculopathy. Most patients with an acute episode of back pain recover within 6-12 weeks, but at least a third go on to have a recurrent episode within 1 year. Various invasive treatments, such as transforaminal steroid injection and discectomy, may speed up recovery from radiculopathy, but the long-term benefits of invasive treatment are uncertain.
AD - Royal Adelaide Hospital, Adelaide, SA, Australia. timothy.kleinig@health.sa.gov.au. AN - 22004395 BT - Medical Journal of Australia DA - 229541307459 ET - 2011/10/19 LA - eng M1 - 8 N1 - Kleinig, Timothy JBrophy, Brian PMaher, Chris GAustraliaThe Medical journal of AustraliaMed J Aust. 2011 Oct 17;195(8):454-7. N2 -Back pain is very common; it has a point prevalence of 25% and is the third most common reason for consultation in Australian general practice. A thorough history and examination can identify the minority of patients who require urgent neuroimaging or other targeted investigations. Careful correlation of clinical and radiological findings is required when abnormal neurological findings are detected. Radiological investigations may detect abnormalities at multiple levels but cannot confirm which level is primarily responsible for a patient's symptoms. A trial of conservative treatment is appropriate, even in cases of radiculopathy. Most patients with an acute episode of back pain recover within 6-12 weeks, but at least a third go on to have a recurrent episode within 1 year. Various invasive treatments, such as transforaminal steroid injection and discectomy, may speed up recovery from radiculopathy, but the long-term benefits of invasive treatment are uncertain.
PY - 2011 SN - 1326-5377 (Electronic)0025-729X (Linking) SP - 454 EP - 7 T2 - Medical Journal of Australia TI - Back pain and leg weakness VL - 195 ER -