[Commonplace and yet underestimated: The demanding treatment of chronic back pain : Evidence-based diagnostics, treatment and critical reflection of the guidelines].

Back pain is among the leading causes of disability and work absenteeism worldwide. Approximately 85-90% of cases are classified as non-specific and mostly show an innocuous trajectory. Decisive for the guideline-conform management are the structured differentiation of specific causes, early identification of chronicity risk factors and an activating biopsychosocial treatment approach. Imaging should only be performed when clinically indicated. Exercise therapy represents the central conservative treatment modality. Pharmacotherapies are mainly used to support active rehabilitation strategies. Interdisciplinary multimodal programs improve long-term function, participation and quality of life, particularly in chronic pain conditions. Interventional procedures can be meaningful in selected patients with clearly defined indications.