The causes of back pain are varied and a precise diagnosis will elude the examiner in about 60% of cases. Examination must be thorough, based initially on a careful history and examination before more sophisticated tests are used. Routine X-rays should be avoided where possible as radiological scanning techniques allow a more precise diagnosis to be made in some patients. Treatment should be simple and non-invasive in most patients. The most important part of such treatment is to ensure that the patient understands the reason for avoiding surgery and seeks to learn how to control the pain in everyday life.
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