Nonsurgical care of low back pain.

R. A. Deyo

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


Based on accumulating evidence, an important shift in the nonsurgical treatment paradigm for low back pain is underway. This shift is away from prolonged rest and passive therapy toward earlier patient activation and greater use of exercise therapy. The patient's best interest is often served by encouraging an early return to work and by avoiding adversarial legal proceedings. Patients should be reassured about the good prognosis of acute pain, and the alarming terminology of "injury" or "ruptured disc" should be avoided. Intervention to avoid sedentariness, smoking, and obesity probably offers important therapeutic and preventive opportunities. When surgery is indicated, the patient should have a major role in decision making after being provided an accurate view of risks and benefits of surgical intervention. Surgery should generally be reserved for those cases for which a benefit of surgery has been clearly established, avoiding the liberalization of indications to include imaging findings alone, persistent pain alone, or the failure of other treatments in the absence of clear surgical indications.

Original languageEnglish (US)
Pages (from-to)851-862
Number of pages12
JournalNeurosurgery clinics of North America
Issue number4
StatePublished - Oct 1991
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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