• Ke Ma, Zhi-Gang Zhuang, Lin Wang, Xian-Guo Liu, Li-Juan Lu, Xiao-Qiu Yang, Yan Lu, Zhi-Jian Fu, Tao Song, Dong Huang, Hui Liu, You-Qing Huang, Bao-Gan Peng, and Yan-Qing Liu.
• Department of Algology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
• Pain Res Manag. 2019 Jan 1; 2019: 8957847.

AbstractChronic nonspecific low back pain (CNLBP) is defined as pain or discomfort originating from the waist, which lasts for at least 12 weeks, but no radiculopathy or specific spinal diseases. CNLBP is a complicated medical problem and places a huge burden on healthcare systems. Clinical manifestation of CNLBP includes discogenic LBP, zygapophyseal joint pain, sacroiliac joint pain, and lumbar muscle strain. Further evaluation should be completed to confirm the diagnosis including auxiliary examination, functional assessment, and clinical assessment. The principle of the management is to relieve pain, restore function, and avoid recurrence. Treatment includes conservative treatment, minimally invasive treatment, and rehabilitation. Pharmacologic therapy is the first-line treatment of nonspecific LBP, and it is most widely used in clinical practice. Interventional therapy should be considered only after failure of medication and physical therapy. Multidisciplinary rehabilitation can improve physical function and alleviate short-term and long-term pain. The emphasis should be put on the prevention of NLBP and reducing relevant risk factors.

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