Basildon EM Handbook 2018

Chronic mechanical back pain

March 2018 | by EMauthor

Common problem, usually caused by multitude of mechanical or inflammatory conditions affecting the ligaments, discs or facet joints.  There is no evidence of nerve root irritation or compression.  Patient usually present with exacerbation of symptoms

Management

•X-rays are not indicated unless there is history of significant back injury prior to presentation

•Adequate analgesia / NSAID will control the pain

•Reassurance and explanation of the condition is important

•There no need for referral to orthopaedic SHO unless there are features of nerve root pain not responding to strong analgesia or cauda equina syndrome

•Please do not refer to fracture clinic or to review clinic. They should referred back to the GP

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