A practical approach to the patient with back pain

Management of back pain is most likely to be effective when treatment is based on a specific diagnosis, when patients are followed proactively to recovery and when psychosocial factors receive appropriate attention. Selected non-habit-forming drugs are useful, especially when taken on a regular basis rather than on an ''as needed'' basis. Rest is less useful in the management of back pain than previously believed and may be counterproductive. Surgery has value only in carefully selected patients, primarily those with well-documented sciatic nerve injury that has not responded to a course of conservative treatment.