Primary care
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A variety of nonoperative interventions are available to treat back pain. Careful assessment, discussion, and planning need to be performed to individualize care to each patient. ⋯ Evidence is poor from randomized controlled trials regarding local injections, Botox, and coblation nucleoplasty; however, with a focused approach, the right treatment can be provided for the right patient. To be more effective in management of back pain, further high-grade randomized controlled trials on efficacy and safety are needed.
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Adequate treatment of low back pain is essential, but has been challenging for many primary care physicians. Most patients with low back pain can be treated in the primary care environment, provided the physician has enough knowledge of the medications used to treat low back pain. ⋯ For patients with chronic back pain, the goal is continual pain management and prevention of future exacerbations. This article reviews current pharmacological options for the treatment of low back pain, and possible future innovations.
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Pain by definition is subjective. A variety of neural pathways are involved in the generation and propagation of pain. Pain is emotional. ⋯ Many potential pain generators are present in the low back. The most likely source of pain is the intervertebral disc. Treating pain requires a multifactorial approach, because pain is very complex.