Approach to Low Back Pain and Peripheral Nerve Stimulation

Introduction

Low back pain is an extremely common presenting complaint that occurs in upwards of 80% of the population. Chronic back pain (>12 weeks’ duration) develops in a small percentage of patients. The first step in the treatment of low back pain is to evaluate for and rule out “red-flag signs.” A complete history and physical exam are critical to creating a differential diagnosis and diagnostic work-up. Routine magnetic resonance imaging (MRI) for acute low back pain is not indicated. Imaging is an integral part of the clinical examination of the patient; it is, however, often used excessively and without consideration of the underlying literature.