In the absence of Red Flags, a patient with LBP symptoms >4 weeks should be given continual assurance that there is no evidence of serious underlying spinal pathology and that recovery should be expected. The patient should also be given safe and effective methods of symptom control and activity modification to help build up activity tolerance.
Psychosocial, economic and occupational factors can significantly alter response to back symptoms and to treatment. Patient expectations and stressors at home and work should be explored before considering referral for a more extensive evaluation or treatment program.
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