ABSTRACT
The medical management of the patient with chronic lower back pain (CLBP) is a process that has evolved over time. Prior evaluation and treatment recommendations using a bioanatomic model of low back pain have given way to a newer biopsychosocial model. This model is, as will be discussed, more multidimensional and patient-centric. For example, treatment efficacy is higher when patient’s thoughts, beliefs, attitudes, and expectations are taken into account. Physical therapists, chiropractors, as well as osteopathic-trained physicians, in many countries provide a significant amount of care for CLBP patients. Occupational therapists can be valuable particularly in assessing work or home ergonomic issues for CLBP patients as well. Chronic low back pain is defined and distinguished from acute pain by symptom duration, treatment responses, the concept of neuroplasticity of the central nervous system, and the relationship of symptoms to the initial noxious stimulus.
