Low back pain is a symptom associated with about 60 different problems that range from muscle strains to spondyloarthritis to osteomyelitis. In a presentation at the 2013 ACR State-of-the-Art Clinical Symposium, held April 20–21 in Chicago, David Borenstein, MD, said that low back pain is challenging for physicians, given the multiple therapies available, the differences between acute and chronic pain, the conflicting research about the effectiveness of the therapies, and the time often required to find an adequate solution for chronic pain.
“Most of us don’t believe that we take care of pain and think that we only take care of the immune system. But, in fact, we do take care of pain, and it is an important part of our job as rheumatologists,” he said. There is little consensus among experts about the definition of low back pain, the differences between chronic and acute low back pain, or how research studies should be designed, said Dr. Borenstein, clinical professor of medicine at the George Washington University Medical Center in Washington, D.C. There is consensus, however, that no single therapy is adequate to treat all chronic pain.