Symptoms persist for more than six months in only 4 percent of the cases, but this group accounts for 85 percent of the cost of low back pain. About half of the people with chronic back pain return to work. Diagnosis Physicians should determine whether pain is musculoskeletal, neurological, or from one of the organs. This diagnosis is based on a careful history and physical examination. Imaging procedures that assist in identifying the pain source include the x-ray, bone scan, computerized tomography, CT myelogram, and magnetic resonance imaging.
Electrical studies are sometimes helpful.
Expensive imaging procedures are generally reserved for patients whose diagnosis is not apparent with more conventional diagnostic techniques, like physical examination. Patients should avoid any activity that increases the pain. For persistent pain, assistance from a rheumatologist should be obtained. Treatment should be directed at the specific cause of pain. Management techniques include pain relievers, anti-inflammatories, antidepressants, muscle relaxants, and rehabilitation exercises.