Guideline-Based Care for Acute Low Back Pain
Guidelines for Diagnosis and Treatment of Low Back Pain developed by the American College of Physicians and the American Pain Society are available here. The American Academy of Family Physicians endorses these guidelines and provides a summary of key recommendations including:
-
A focused history and physical examination should be conducted that includes assessment of psychosocial risk factors, which predict risk for chronic disabling back pain.
-
Patients should be provided with evidence-based information on low back pain with regard to their expected course, advised to remain active, and provided information about effective self-care options.
Recognizing "red flags" in acute low back pain: In primary care, up to 90% of patients have non-specific low back pain without specific pathology. However, features of history and physical exam that can identify patients more likely to have serious conditions such as spinal malignancy, infection, or cauda equina syndrome (“red flags”) or other conditions that may respond to specific treatments (e.g., nerve root compression, spinal stenosis, ankylosing spondylitis, and vertebral compression fracture) are important for guiding diagnosis and therapy. Recommendations for completing a focused history and physical exam when evaluating low back pain are available in Clinical Practice Guidelines.
In addition to the above, guidelines for nonpharmacological treatments for low back pain are available online in Annals of Internal Medicine. Read More
Resources for Patient Education
Below are some resources to help provide education to patients with low back pain:
- ACP Patient FACTS Handout for Low Back Pain (available in English only)
- ACP HEALTH TiPS Handout for Low Back Pain (available in English or Spanish)
- Familydoctor.org has information on low back pain