TY - JOUR T1 - Back pain — reducing long-term problems JF - British Journal of General Practice JO - Br J Gen Pract SP - 324 LP - 326 VL - 56 IS - 526 AU - Paul Hepple AU - Ann RR Robertson Y1 - 2006/05/01 UR - http://bjgp.org/content/56/526/324.abstract N2 - In a 1998 survey in Great Britain, one in 12 adults aged 25–44 years reported having back pain lasting over 1 year.1 Although 90% of patients with non-specific back pain stop consulting within 3 months, only 25% will have completely recovered after 1 year. Approximately 6% will go on to become chronically disabled.2A key role of a GP should be to help reduce the number of patients presenting with acute lower back pain from going on to develop chronic pain, disability and loss of work. Unfortunately, back pain, being a symptom rather than a disease, suffers from a lack of understanding of its mechanism and a lack of evidence as to which intervention helps a particular patient. However, an escalation of back pain research and a shift in emphasis towards trying to identify early risk factors for chronic pain and disability have the potential to improve GP care and patients' outcomes, particularly outcomes for those who may be vulnerable to developing chronic back pain.Patients presenting with acute back pain should initially be assessed into one of three groups:3 non-specific low back pain (the vast majority), those with possible nerve root problems and lastly those with red flags for possible serious spinal pathology. These red flags include: age of onset <20 or over 55 years, past history of carcinoma, systemically unwell or weight loss, structural deformity, constant progressive non-mechanical type pain and widespread neurological symptoms. For the rest of … ER -