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CME Objective: To review current evidence for prevention, diagnosis, treatment, and practice improvement of low back pain.
Funding Source: American College of Physicians.
Disclosures: Dr. Chou, ACP Contributing Author, has disclosed the following conflicts of interest: Payment for manuscript preparation: American College of Physicians. Consultancy: Palladian. Grants/grants pending: Agency for Healthcare Research and Quality. Royalties: UptoDate. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-1032.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer.
With the assistance of additional physician writers, Annals of Internal Medicine editors develop In the Clinic using resources of the American College of Physicians, including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program).
Low back pain has a lifetime prevalence of nearly 80%, and spinal disorders are the fourth most common primary diagnosis for office visits in the United States (1). Low back pain is also costly, accounting for a large and increasing proportion of health care expenditures without evidence of corresponding improvements in outcomes (2). In most patients, the specific cause of low back pain cannot be identified, and episodes generally resolve within days to a few weeks with self-care. Up to one third of patients, however, report persistent back pain of at least moderate intensity 1 year after an acute episode, and 1 in 5 report substantial limitations in activity (3). Because low back pain is common, can lead to substantial disability, and can become chronic, proficiency in evaluation and management is important.
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Clinical Slide Set. Low Back Pain
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