366 Ch 365. Back and Neck Pain

Low back pain (LBP) = ~ 80% lifetime prevalence + leading cause of disability worldwide；neck pain ~ 30-50% annual prevalence；acute < 6 weeks, subacute 6-12 weeks, chronic > 12 weeks；~ 85% non-specific (mechanical) — diagnosis without imaging in absence of red flags；red flags for serious cause: trauma, age < 18 or > 50, fever, weight loss, IV drug use, cancer history, immunosuppression, neurological deficit (cauda equina!), saddle anesthesia, bowel/bladder dysfunction, structural deformity, refractory pain；specific causes: disc herniation (radiculopathy), spinal stenosis (neurogenic claudication), spondylolisthesis, vertebral compression fracture, malignancy (metastasis, multiple myeloma), infection (spinal epidural abscess, osteomyelitis, discitis), inflammatory (ankylosing spondylitis, SpA), cauda equina syndrome (EMERGENCY)；treatment: stay active + NSAIDs + heat/cold + PT + targeted (steroid injections, RFA, surgery for select)；imaging: not for acute non-specific LBP < 6 weeks without red flags。