Diagnostics and minimally invasive therapy for chronic low back pain

Chronic low back pain is one of the most frequent causes for seeking medical help in Germany. Many factors play a causal role in its pathogenesis. This is where the dilemma resides in narrowing down the diagnosis and deciding on subsequent therapeutic intervention. There is overall agreement on the concept of when it is expedient to initiate further diagnostic measures. With the exception of clear pathomorphological findings and the presence of cardinal symptoms or warning signs, so-called "red flags", primary back pain should not be subjected to any specific diagnostic tests and therapy during the first 3 months. We present well-established techniques for blockade, discography, and minimally invasive treatment options such as cryotherapy, procedures for thermal ablation, and intradiscal electrotherapy. Vertebroplasty, currently a frequently applied method, is also included in the discussion of minimally invasive treatment for chronic low back pain.