The principle considerations and
recommendations for assessment and treatment of low back
pain patients are as follows:
Patients must have an initial
assessment to rule out serious systemic or local
disease. This will include a medical history and
physical examination. One of the greatest challenges for
the physician is making an accurate diagnosis which will
dictate the optimal treatment.
should institute effective initial management to reduce
the rate of recurrence and chronicity. If the symptoms
have not resolved in the first four weeks with
medications and activity modification, VAX-D should be
considered for those patients with disc related pain.
In general, discogenic conditions
will include annular tears, disc protrusion, herniation
and extrusion, sequestration, Internal Disc Disruption (IDD)
and degenerative disc disease. The disc can affect the
lateral nerve roots causing other symptoms such as pain,
numbness and motor loss in the leg and foot.
Only patients with progressive
neurological deficit, cauda equina syndrome, or spinal
instability are considered early surgical candidates.
indicates that in the absence of the above conditions,
surgical patients have the same long-term outcomes as
those who receive effective non-surgical care.