Assessment and nonsurgical management of low back pain: a narrative review

Park SC, Sung Cheol Park, Kang MS, Min-Seok Kang, Yang JH, Jae Hyuk Yang, Tae-Hoon Kim, Kim TH
The Korean journal of internal medicine · 2023 · vol. 38(1) , pp. 16–26 · doi:10.3904/kjim.2022.250 · PMID:36420562 · PMC9816685
Review OA: gold
📄 Open PDF Full text JSON View on PubMed View at publisher
⚙ AI-generated summary by qwen3.7-flash, 2026-10-12 ⓘ

This narrative review assesses low back pain etiology and management, emphasizing the importance of identifying red flags and utilizing multidisciplinary rehabilitation combined with prudent medication use for patients unresponsive to first-line therapy.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-10-12 · read from full text ⓘ

This narrative review examines the assessment and nonsurgical management of low back pain, highlighting the challenges in distinguishing among its diverse etiologies such as mechanical, neuropathic, and systemic causes. The authors emphasize that while low back pain is highly prevalent and often self-limiting, psychological factors significantly influence the transition to chronicity, necessitating a tailored approach involving patient education, lifestyle modifications, and various physiotherapy techniques. Although imaging is generally reserved for cases with red flags or persistent symptoms due to limited diagnostic utility in early stages, the review notes that definitive diagnoses are rarely achieved in the majority of patients. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Low back pain (LBP) is a common condition that affects people of all ages and income levels worldwide. The etiology of LBP may be mechanical, neuropathic, systemic, referred visceral, or secondary to other causes. Despite numerous studies, the diagnosis and management of LBP remain challenging due to the complex biomechanics of the spine and confounding factors, such as trivial degenerative imaging findings irrelevant to symptoms and psychological and emotional factors. However, it is imperative to identify the crucial signs ("red flags") indicating a serious underlying condition. While many recent guidelines emphasize non-pharmacologic management approaches, such as education, reassurance, and physical and psychological care, as the first option, LBP patients in many countries, including South Korea, are prescribed medications. Multidisciplinary rehabilitation combined with prudent use of medications is required in patients unresponsive to first-line therapy. The development of practical guidelines apposite for South Korea is needed with multidisciplinary discussion.
Full text 24,969 characters · extracted from pmc-nxml · 3 sections · click to expand

Intro

Despite considerable progress in the diagnosis and treatment of low back pain (LBP), distinguishing among its many possible etiologies, and thus determining the most appropriate management approach, remains challenging [ 1 – 3 ]. Therefore, while this review does not provide standards for the management of LBP, it does present evidence-based information on its diagnosis and nonsurgical treatment. Nonetheless, it should be noted that our review is based on studies with varying levels of evidence, some of which addressed highly specific aspects of LBP. Our findings should therefore be interpreted with caution.

Other

This review had several limitations. First, it was a narrative rather than systematic review or meta-analysis. Therefore, bias in the literature search or selection cannot be ruled out. In addition, the treatment modalities were not graded according to the level of evidence. Second, LBP is an extremely broad comprehensive category, such that its mechanisms, etiologies, examinations, and management protocols remain controversial. Third, given the lack of conclusive evidence supporting any one treatment option unconditionally, we cannot provide definitive recommendations for the management of LBP. Despite these limitations, this review provided an overview of the LBP management process and can thus act as a guide for physicians involved in the treatment of this common condition.

Conclusions

Despite a plethora of studies, trials, and clinical guidelines regarding the nonsurgical management of LBP, gaps remain between their recommendations and actual practice, depending on the health system and economic status of a given country, as well as patient behaviors and demographics. In South Korea, the lack of apposite guidelines often results in inappropriate imaging or drug prescriptions and subsequent substantial and unnecessary medical costs. Multidisciplinary discussions with clinicians from various departments, researchers, pharmaceutical companies, and lawmakers are required to devise practical guidelines. Ultimately, it is essential to comply with the basic principles of care, taking into account the benefits and potential risks of treatment.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: pmc-nxml ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

MeSH descriptors

Low Back Pain Low Back Pain Low Back Pain Humans Republic of Korea Spine

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. The paper's references may be in our DB but unresolved to ``paper_id`` (resolution happens at ingest when the cited DOI matches a row we already have). Run the cross-source citation reconcile pass to retry.

Source provenance

europepmc
last seen: 2026-10-11T09:27:45.537177+00:00
pubmed
last seen: 2026-10-12T06:16:30.493817+00:00