Nursing Guide to Back Pain: Nursing Diagnosis, Interventions, & Care Plans

Back Pain Etiology and Epidemiology 

Chronic low back pain (CLBP) causes major welfare and economic problems in the U.S. and is the second leading cause of disability nationally. In adults, CLBP has increased dramatically in the last decade and continues to have a high prevalence among the aging population. CLBP affects both men and women within each ethic group, with a significant impact on functional ability and occupational activities. The complexity of this condition causes diagnosis to be challenging. It requires the healthcare provider to use complex clinical decision-making skills. 

Traditionally, the cause of most CLBP cases were unknown, therefore misdiagnosis occurred often. In most cases, CLBP is caused by a specific pain generator presenting with its own characteristics and with different therapeutic opportunities (Pavelka et.al, 2019). 

Within the U.S., the total cost for CLBP exceeds 100 billion dollars a year (Shmagel et al., 2016). Two-thirds of this cost is accounted to through lost wages and decreased productivity (Pavelka et.al, 2019). Psychological factors such as anxiety, depression, and stress can contribute to CLBP. 

Common causes of CLBP include: 

• Habits 
• Health history (i.e., herniated disk) 
• Psychosocial factors 
• Work 

Complications that may result from CLBP include: 

• Arthritis 
• Insomnia 
• Sciatica 
• Scoliosis 
• Spinal stenosis 
• Weight gain 

Lower Back Pain ICD-10 Code (unspecified): M54.50

Back Pain Diagnosis 

• Assess pain intensity 
• Assess the ability to perform the following: 
  • Lift legs 
  • Sit 
  • Stand 
  • Walk 
• Examine the back 

Back Pain Management 

• Medication 
  • Antidepressants 
  • Muscle relaxants 
  • Over-the-counter or topical pain relievers 
  • Prescribed narcotics 
• Non-pharmacological measures 
  • Short periods of rest 
  • Walking 
  • Yoga 

Back Pain Nursing Care Plan

Nursing Considerations 

Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnosis, interventions, expected outcomes, and education for individuals with back pain are listed below. 

Assessment 

• Duration and propagation of pain 
• Location and nature of pain 
• Leg weakness 
• Weight 

Nursing Diagnosis/Risk For 

• Depression 
• Fatigue 
• Impaired physical mobility 
• Knowledge deficit 
• Pain 
• Social isolation 

Interventions 

• Exercise 
• Manual therapies 
• Treatment through medication 

Expected Outcomes 

• Coping with lifestyle changes 
• Improvements in the following: 
  • Gait and posture 
  • Pain level 
  • Range of motion 
• Increased knowledge on prevention 

Individual/Caregiver Education 

• Create an exercise regimen the individual can follow. 
• Demonstrate proper body mechanics. 
• Educate the individual on how to prevent and treat back pain, as well as the causes of the condition. 

Additional Information

Content Release Date 

4/1/2022

Content Expiration

12/31/2030

Course Contributor 

The content for this course was created by Relias staff writer Tiffany Fields, RN, BSN, MSN, DNP, CRNP. She has been a clinical nurse for over 20 years. Tiffany was educated and trained in Alabama as a Licensed Practical Nurse where she practiced as a Gerontological Nurse at the local Nursing Homes. She earned her Associate Degree in Nursing, Bachelor’s Degree in Nursing, Master’s Degree in Nursing, and Doctorate in Nursing Practice. She also earned a degree as a Certified Family Nurse Practitioner. Her clinical expertise is Adult- Geriatric Nursing and Medical-Surgical medical complexity. She is currently Assistant Director of Nursing at a Rural Hospital along with a writer for Relias. 

Resources 

• A review of work schedule issues and musculoskeletal disorders with an emphasis on the healthcare sector https://www.jstage.jst.go.jp/article/indhealth/46/6/46_6_523/_article 
• Work-related psychosocial risk factors and musculoskeletal disorders in hospital nurses and nursing aides: a systematic review and meta-analysis https://www.sciencedirect.com/science/article/abs/pii/S0020748914002971 
• The biopsychosocial approach to chronic pain: scientific advances and future directions https://pubmed.ncbi.nlm.nih.gov/17592957/ 

References 

• Monie, A. P., Fazey, P. J., & Singer, K. P. (2016). Low back pain misdiagnosis or missed diagnosis: Core principles. Manual Therapy, 22, 68-71. https://www.sciencedirect.com/science/article/abs/pii/S1356689X15001939?via%3Dihub 
• Pavelka, K., Jarosova, H., Sleglova, O., Svobodova, R., Votavova, M., Milani, L., ... & Meroni, A. 
• M. (2019). Chronic low back pain: Current pharmacotherapeutic therapies and a new biological approach. Current Medicinal Chemistry, 26(6), 1019-1026. https://www.eurekaselect.com/article/90366 
• Shmagel, A., Foley, R., & Ibrahim, H. (2016). Epidemiology of chronic low back pain in US adults: data from the 2009–2010 National Health and Nutrition Examination Survey. Arthritis Care & Research, 68(11), 1688-1694. https://acrjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/acr.22890 
• Tan, A., Zhou, J., Kuo, Y. F., & Goodwin, J. S. (2016). Variation among primary care physicians in the use of imaging for older patients with acute low back pain. Journal of General Internal Medicine, 31(2), 156-163. https://link.springer.com/article/10.1007/s11606-015-3475-3