**5.3 Low back pain**

The term "low back pain (LBP)" refers to pain, muscle tension, or stiffness that occurs below the costal border and above the inferior gluteal folds, and maybe associated with or without sciatica (pain traveling down the leg from the lower back) [44]. Even though many patients with back pain recover within a year, some will develop a chronic illness characterized by fluctuating or persistent pain of low or medium severity that is punctuated by periods of no pain or painful exacerbation [45]. Non-specific low back pain (NSLBP) is the most common type of LBP. When the pathoanatomical source of the pain cannot be ascertained, this term is used [46]. The underlying pathophysiology of NSLBP is, by definition, unknown. Therefore, treatment is primarily focused on alleviating pain symptoms, and a variety of pharmacological and non-pharmacological intervention modalities are utilized in clinical practice to achieve this goal [47]. Various pharmacological treatments for low back pain are associated with low to moderate, primarily short-term effects on pain. According to new research, acetaminophen is ineffective for acute low back pain, while duloxetine has only the modest effects on chronic low back pain [48]. Acupuncture, stretching, heat application, massage, and manual spinal manipulation are among the non-pharmacological treatments recommended by the American College of Physicians for acute and chronic non-radicular low back pain (non-radicular LBP) in their clinical practice recommendations [45].
