Guideline: In low back pain, nonpharmacologic treatments are recommended

  • Somerville, Simon MBBS, MSc, FRCGP, GP

  • Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, England, UK

Source of funding: No external funding.

For correspondence: Dr. A. Qaseem, American College of Physicians, Philadelphia, PA, USA. E-mail [email protected].

Ratings for this resource:

General Internal Medicine, Family Practice, General Practice

Physical Medicine & Rehabilitation

ACP Journal Club 166(12):p JC62, June 2017.

Guideline scope

A guideline developed by the American College of Physicians (ACP) Clinical Guidelines Committee on managing adults with acute, subacute, or chronic low back pain (LBP) in primary care.

Guideline development methods

The guideline was based on the results of systemic reviews of pharmacologic and nonpharmacologic treatments for acute, subacute, or chronic LBP in adults ≥ 18 years of age conducted by the Agency for Healthcare Research and Quality. Searches were done from Jan 2008 to Nov 2016; studies published before 2007 were identified from systematic reviews published in 2007. The guideline was reviewed by journal peer reviewers and ACP Regents and Governors.

Recommendations

Recommendations are summarized in the Table.

Conclusions

ACP recommends initial nonpharmacologic treatment for acute, subacute, or chronic low back pain. Pharmacologic treatment should be considered when nonpharmacologic treatments have failed in the chronic setting or when desired for patients with acute or subacute pain.

ACP © Journal Club and Best Evidence Copyright 2017 American College of Physicians - American Society of Internal Medicine. All rights reserved.