Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment

  • Ivan UritsEmail author
  • Aaron Burshtein
  • Medha Sharma
  • Lauren Testa
  • Peter A. Gold
  • Vwaire Orhurhu
  • Omar Viswanath
  • Mark R. Jones
  • Moises A. Sidransky
  • Boris Spektor
  • Alan D. Kaye
Other Pain (A. Kaye and N. Vadivelu, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Other Pain


Purpose of Review

Low back pain encompasses three distinct sources: axial lumbosacral, radicular, and referred pain. Annually, the prevalence of low back pain in the general US adult population is 10–30%, and the lifetime prevalence of US adults is as high as 65–80%.

Recent Findings

Patient history, physical exam, and diagnostic testing are important components to accurate diagnosis and identification of patient pathophysiology. Etiologies of low back pain include myofascial pain, facet joint pain, sacroiliac joint pain, discogenic pain, spinal stenosis, and failed back surgery. In chronic back pain patients, a multidisciplinary, logical approach to treatment is most effective and can include multimodal medical, psychological, physical, and interventional approaches.


Low back pain is a difficult condition to effectively treat and continues to affect millions of Americans every year. In the current investigation, we present a comprehensive review of low back pain and discuss associated pathophysiology, diagnosis, and treatment.


Low back pain Axial low back pain Referred low back pain Radiculopathy Lumbosacral pain 


Compliance with Ethical Standards

Conflict of Interest

Ivan Urits, Aaron Burshtein, Medha Sharma, Lauren Testa, Peter A. Gold, Vwaire Orhurhu, Omar Viswanath, Mark R. Jones, Moises A. Sidransky, and Boris Spektor declare no conflict of interest. Dr. Kaye is a speaker for Depomed, Inc. and Merck, Inc.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Ivan Urits
    • 1
    Email author
  • Aaron Burshtein
    • 2
  • Medha Sharma
    • 1
  • Lauren Testa
    • 1
  • Peter A. Gold
    • 2
  • Vwaire Orhurhu
    • 1
  • Omar Viswanath
    • 3
    • 4
    • 5
  • Mark R. Jones
    • 1
  • Moises A. Sidransky
    • 6
  • Boris Spektor
    • 7
  • Alan D. Kaye
    • 8
  1. 1.Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA
  2. 2.Department of Orthopedic SurgeryHofstra-Northwell Health SystemGreat NeckUSA
  3. 3.Valley Anesthesiology and Pain ConsultantsPhoenixUSA
  4. 4.Department of AnesthesiologyUniversity of Arizona College of Medicine-PhoenixPhoenixUSA
  5. 5.Department of AnesthesiologyCreighton University School of MedicineOmahaUSA
  6. 6.Department of AnesthesiologyUniversity of Arizona College of Medicine-PhoenixTylerUSA
  7. 7.Department of AnesthesiologyEmory School of MedicineAtlantaUSA
  8. 8.Department of AnesthesiologyLouisiana State University Health Science CenterNew OrleansUSA

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