ABSTRACT
Chronic back pain is defined as pain that persists longer than 12 weeks and that occurs frequently or daily. It continues to be one of the most prevalent and burdensome global health problems; individuals who experience chronic back pain are at high risk for significant disability, absence from work, lost productivity, and other psychosocial comorbidities. The etiology, clinical presentation, treatment, and outcomes for back pain are extremely heterogeneous. Further, evidence suggests that labeling patients with reference to specific anatomical defects is unlikely to improve outcomes in most cases. This chapter emphasizes conservative approaches for the evaluation, treatment, and management of chronic back pain organized by primary, secondary, and tertiary levels of care. New and traditional assessment instruments for initial psychosocial evaluation, presurgical screening, and tracking of symptoms and functioning are reviewed. This chapter also discusses specific empirically supported treatments (e.g., cognitive-behavioral therapy, interdisciplinary pain rehabilitation) that promote coordinated and personalized intervention, functional restoration, and quality of life.
