Low back pain is a challenge in daily clinical activity. The prognosis for single episodes of acute pain is good, but many patients have persistent/recurrent illness, often characterized by a complex pattern of somatic, psychological and social factors. The aim of this article is to present the evidence-based recommendations in the Norwegian clinical guidelines and to discuss new knowledge.
The Norwegian guidelines for diagnosis and treatment of low back pain of 2007, are based on literature searches that were completed in 2005. This article presents the main content of those national guidelines and assessment of new knowledge based on more recent Cochrane reviews and relevant articles.
Low back pain can be categorized according to development over time, etiology or a diagnostic triad with so-called red, green or yellow flags. Diagnostic imaging is recommended after four to six weeks duration without improval. A main treatment goal is to provide early and sufficient pain reduction. It is also important to regain normal daily activities as soon as possible.
Low back pain often resolves without treatment within a few weeks. Adequate diagnostic categorization and good pain alleviation is possible with simple means in most patients. Simple diagnostic measures can help to identify individuals with serious pathology.