RT Book, Section A1 Webb, Charles W. A1 O’Connor, Francis G. A2 South-Paul, Jeannette E. A2 Matheny, Samuel C. A2 Lewis, Evelyn L. SR Print(0) ID 1106848839 T1 Low Back Pain in Primary Care: An Evidence-Based Approach T2 CURRENT Diagnosis & Treatment: Family Medicine, 4e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071827454 LK accessmedicine.mhmedical.com/content.aspx?aid=1106848839 RD 2024/03/28 AB Low back pain (LBP), discomfort, tension, or stiffness below the costal margin and above the inferior gluteal folds, is one of the most common conditions encountered in primary care as an acute self-limited problem, second only to the common cold. LBP has an annual incidence of 5%, and a lifetime prevalence of 60−90%. It is the leading cause of disability in the United States for adults aged <45 years, is a leading cause of non−battle injury air evacuation from recent military deployments, and is responsible for one-third of workers’ compensation costs and accounts for direct and indirect of nearly $90 billion per year. At any given time 1% of the US population is chronically disabled and another 1% temporarily disabled as a result of back pain. Numerous studies report a favorable natural history for acute and subacute LBP, with <90% of patients regaining function within 6−12 weeks with or without physician intervention. Recent evidence suggests that about one in five acute LBP patients will have persistent back pain resulting in limitations in activity at 1 year. Approximately 85% of back pain has no readily identifiable cause, and up to one-third of all patients will develop chronic low back pain. This chapter reviews a detailed evidence-based approach to the assessment, diagnosis, and management of the adult patient with acute, subacute, and chronic LBP.