| Diagnosis and treatment of acute low back pain. | |
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MedLine Citation:
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PMID: 22335313 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Acute low back pain is one of the most common reasons for adults to see a family physician. Although most patients recover quickly with minimal treatment, proper evaluation is imperative to identify rare cases of serious underlying pathology. Certain red flags should prompt aggressive treatment or referral to a spine specialist, whereas others are less concerning. Serious red flags include significant trauma related to age (i.e., injury related to a fall from a height or motor vehicle crash in a young patient, or from a minor fall or heavy lifting in a patient with osteoporosis or possible osteoporosis), major or progressive motor or sensory deficit, new-onset bowel or bladder incontinence or urinary retention, loss of anal sphincter tone, saddle anesthesia, history of cancer metastatic to bone, and suspected spinal infection. Without clinical signs of serious pathology, diagnostic imaging and laboratory testing often are not required. Although there are numerous treatments for nonspecific acute low back pain, most have little evidence of benefit. Patient education and medications such as nonsteroidal anti-inflammatory drugs, acetaminophen, and muscle relaxants are beneficial. Bed rest should be avoided if possible. Exercises directed by a physical therapist, such as the McKenzie method and spine stabilization exercises, may decrease recurrent pain and need for health care services. Spinal manipulation and chiropractic techniques are no more effective than established medical treatments, and adding them to established treatments does not improve outcomes. No substantial benefit has been shown with oral steroids, acupuncture, massage, traction, lumbar supports, or regular exercise programs. |
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Authors:
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Brian A Casazza |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: American family physician Volume: 85 ISSN: 1532-0650 ISO Abbreviation: Am Fam Physician Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-02-16 Completed Date: 2012-04-23 Revised Date: 2013-02-01 |
Medline Journal Info:
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Nlm Unique ID: 1272646 Medline TA: Am Fam Physician Country: United States |
Other Details:
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Languages: eng Pagination: 343-50 Citation Subset: AIM; IM |
Affiliation:
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University of North Carolina School of Medicine, Chapel Hill, NC, USA. brian_casazza@med.unc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Analgesics, Opioid / therapeutic use Anti-Inflammatory Agents, Non-Steroidal / therapeutic use Exercise Therapy Humans Low Back Pain* / diagnosis, etiology, therapy Muscle Relaxants, Central / therapeutic use Patient Education as Topic Physical Examination |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Opioid; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Muscle Relaxants, Central |
| Comments/Corrections | |
Comment In:
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Am Fam Physician. 2012 Nov 1;86(9):online; author reply online
[PMID:
23113467
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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