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New Guideline for Low Back Pain Management

The American College of Physicians and the American Pain Society have published an updated practice guideline for the management of low back pain in primary care.

The guideline, which appears in the current Annals of Internal Medicine, includes recommendations on both evaluation and treatment. Among the recommendations:

• Imaging should not be part of the routine work-up of patients with nonspecific pain.
  
• Clinicians should provide patients with information on the expected course of their condition.
  
• When considering medication use, clinicians should usually start with acetaminophen or NSAIDs.
  
• For patients who do not improve, nondrug therapies such as spinal manipulation, acupuncture, and yoga may be considered.
  

The ACP and APS also provide an algorithm for the initial evaluation and subsequent management of patients.

LINK(S):

Annals of Internal Medicine guideline paper (Free)

Annals of Internal Medicine review of evidence on nonpharmacologic therapies for back pain (Free)

Annals of Internal Medicine review of evidence on medications for back pain (Free)

Published in Physician's First Watch October 3, 2007