Chronic back pain

The basic management of the patient with uncomplicated chronic back pain should follow the following guidelines:

• back education program and ongoing support

• encouragement of normal activity

• exercise program

• analgesics, e.g. paracetamol

• NSAIDs for 10-14 days (only if inflammation, i.e. pain at rest—relieved by activity)

• trial of mobilisation or manipulation (at least 3 treatments)—if no contraindications 11 12

• consider trigger point injection

• a multidisciplinary team approach is recommended

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