management in general practice

Last reviewed 06/2023

The main function of the general practitioner in the management of back pain is diagnostic - providing the triage distinguishing psychosocial problems presenting as back pain from the three main types of organic back pain:

• low back pain
• nerve root pain
• other (serious) causes of back pain

The history provides most of the information distinguishing the most likely entity, but an initial examination may provide additional information.

The main features of the examination include:

• defining the exact site of the pain
• review of how the back can move
• power in the limbs and toes
• straight leg raising
• reflexes

Remember to enquire at some stage whether the patient has noticed any change or problem with their bowel and bladder function.