Introduction DIAGNOSTIC Low Back Pain: History and Physical Examination The Appropriate Utilization of Imaging Studies for Disorders of the Lumbar Spine Electrodiagnosis and Lumbar Spine Disorders Diagnostic Spinal Injections for Low Back Pain The Functional Capacity Evaluation TREATMENT Exercise Rehabilitation for Occupational Low Back Pain The Use of Medications in the Treatment of Low Back Pain Therapeutic Injections for Low Back Pain Manual Medicine The Use of Physical Modalities for Occupational Low Back Pain Lumbosacral Orthotics Operative Intervention for Lumbar Spine Disorders PREVENTION Prevention of Occupational Low Back Pain
Among the strategies to prevent occupational LBP, only job design/redesign and exercise programs appear to have a protective effect; however, the studies pertaining to exercise remain contradictory, and controlled trials evaluating ergonomics interventions are lacking. Risk factor modification is beneficial from a general health perspective, but studies are contradictory with respect to its role in prevention of LBP. There is no conclusive evidence to support the use of structured education programs in the workplace, and the cost of these programs is not justified. There is no support for the use of orthotics or worker selection methods based on the available data, and these methods should not be employed in the workplace. Despite efforts from the medical community and industry, there is little evidence that there has been a substantial impact on the prevalence of LBP and disability. Further work is needed in both occupational and nonoccupational settings to determine effective prevention strategies for LBP in the future.
