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The guidelines, which are published in the journal Annals of Internal Medicine, include a method to guide primary care doctors and other clinicians in gathering and interpreting information during a patient's first visit. This formula would place them in one of three general categories:

• Non-specific low back pain, which affects about 85 percent of patients.
• Back pain potentially associated with spinal conditions, such as spinal stenosis, sciatica or vertebral compression fracture.
• Back pain potentially associated with another specific cause, such as cancer.

Imaging or other diagnostic tests such as MRIs, CAT scans, or X-rays for patients with non-specific low back pain should be reserved for patients with severe or progressive neurological deficits or suspected underlying conditions such as infection or cancer.

The panel of experts who developed the guidelines also reviewed evidence on drug therapies and non-drug treatments for acute and chronic low back pain.

Medication
"Almost all medications reviewed had some benefits, but they have risks," guidelines co-author Roger Chou, head of the American Pain Society Clinical Practice Guidelines Program, said in a prepared statement.

"Acetaminophen, for example, is very safe but might not be effective. NSAIDs have gastrointestinal and cardiovascular risks. Opioids and muscle relaxers can provide relief for those with severe pain, but their potential benefits and risks should be weighed carefully."

"Patients who prefer not to take medication can benefit from non-drug treatments, such as acupuncture, spinal manipulations and massage therapy. None, however, are proven to be more effective than others to warrant recommendation as first-line therapy," Chou said. - (HealthDay News)

Read more:
Backache Centre
Diagnosing back pain
 

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