Conservative, Nonsurgical Management of Low Back Pain in the Primary Care Setting

A BSTRACT Background: Low back pain (LBP) is a prevalent condition managed predominantly in primary care. While a range of treatment options exist, the initial approach should focus on conservative, nonsurgical interventions. Objective: The objective of the study was to describe the evidence-based strategies for conservative, nonoperative treatment of low back pain in the primary care setting. Materials and Methods: A cohort study was conducted at the university medical clinics over 6 months in 2024. It included all consented adult patients, aged 18 and above, presented with LBP without neurological deficits. Participants were categorized into two groups based on clinical diagnosis: Group A had LBP due to muscular spasm, whereas Group B was due to lumbar disc herniation. Both groups received a standardized conservative management protocol, involving nonsteroidal anti-inflammatory drugs (NSAIDs) and up to 6 sessions of physiotherapy over 3 weeks. Results: The study included 128 patients (71 males and 57 females) with a mean age of 54.10 years. Most were retired (36.7%) and overweight/obese (92.2%), whereas 82.8% had prior medical treatment. All received physiotherapy and NSAIDs. The initial mean pain score was 9.63, reduced to 1.55 post-intervention. Overall, 94.5% reported improvement, with Group A showing better outcomes (98.4% vs. 90.6% improved). Post-intervention pain scores also reduced significantly. About 85.2% reported high satisfaction with the regimen of treatment employed. Conclusion: The initial management of LBP should focus on conservative, nonsurgical strategies. This includes physiotherapy and NSAIDs; their conjunction can effectively treat LBP while avoiding unnecessary interventions.