Subacute low back pain – 7-12 weeks of low back pain.
10% of patients with LBP have symptoms that persist > 6 weeks. Differential diagnosis includes causes of acute low back pain and also:
1. continued pain at rest should prompt evaluation for spinal osteomyelitis (especially with fever and elevated ESR) or neoplasm if not already done
2. plain spine X-rays may show possibly causative conditions, although many or all of the following may also be seen in asymptomatic patients
a) spondylolisthesis
b) spinal osteophytes
c) lumbar stenosis
d) Schmorl’s node or nodule: disc herniation through cartilaginous endplate into vertebral body (NB: may also be seen in 19% of asymptomatic patients)
Clinicians should advise patients with acute and subacute low back pain to stay active and continue activities of daily living within the limits permitted by their symptoms.
Clinicians should consider cognitive behavioral therapy in the treatment of subacute low back pain
Exercise is recommended in the treatment of subacute low back pain.
NSAIDs may be used for short-term pain relief in patients with acute and subacute low back pain.
Low evidence: Acupuncture may be used as an adjunct treatment for subacute low back pain.