Low back pain is very common in developed countries, especially in adults of working age.
For acute low back pain, advice to continue ordinary activity can give equivalent or faster symptomatic recovery from the acute attack and lead to less chronic disability and less time off work. Bed rest should not be recommended as a treatment for acute low back pain.
Non-steroidal anti-inflammatory drugs (NSAIDs) are effective for short-term symptomatic relief in patients with acute low back pain. Several types of NSAIDs appear similarly effective, but can have harmful side-effects.
Muscle relaxants (benzodiazepines) are effective at reducing pain for patients with acute low back pain but can have harmful side-effects. Different benzodiazepines appeared to be similarly effective.
There is strong evidence that exercise therapy may help chronic low back pain patients return to normal daily activities and work.
Multidisciplinary treatment programmes, involving components such as education, active exercise programmes, behavioural treatment, relaxation exercises, and work-place visits, can improve long-term outcomes for pain, functional status and sick leave compared with other treatments for chronic low back pain.