Management of low back pain

@article{Cohen2008ManagementOL,
  title={Management of low back pain},
  author={Steven P. Cohen and Charles E. Argoff and Eugene J. Carragee},
  journal={BMJ : British Medical Journal},
  year={2008},
  volume={337}
}
#### Summary points Back pain is the leading cause of occupational disability in the world and the most common cause of missed workdays. As the population ages and our lives become more sedentary, this situation is unlikely to change. We aim here to provide an evidence based overview of low back pain aimed at primary care physicians. The most frequently quoted epidemiological studies cite lifetime adult prevalence rates varying from 50% to 80%, and point prevalence rates from 15% to 30%.1 Yet… 

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References

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Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society

TLDR
This guideline is to present the available evidence for evaluation and management of acute and chronic low back pain in primary care settings and grades its recommendations by using the ACP's clinical practice guidelines grading system.

Bed rest for acute low back pain and sciatica.

TLDR
Differences in effects of advice to stay in bed compared with advice toStay active are small for patients with low back pain with or without sciatica, and there is not an important difference in the effects of bed rest compared with exercises in the treatment of acuteLow back pain.

Diagnostic Evaluation of Low Back Pain with Emphasis on Imaging

TLDR
Taking a history is more useful than physical examination in screening for underlying malignancy, at least in the early stages (Table 2) (7, 10).

Bed rest for acute low-back pain and sciatica.

TLDR
For people with acute LBP, advice to rest in bed is less effective than advice to stay active, and for patients with sciatica, there is moderate quality evidence of little or no difference in pain intensity or functional status between bed rest and exercises.

Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study

TLDR
In this cohort of patients with acute low back pain in primary care, prognosis was not as favourable as claimed in clinical practice guidelines and recovery was slow for most patients.

Clinical Guidelines for the Management of Low Back Pain in Primary Care: An International Comparison

TLDR
The comparison of clinical guidelines for the management of low back pain showed that diagnostic and therapeutic recommendations were generally similar, but there were discrepancies for recommendations regarding exercise therapy, spinal manipulation, muscle relaxants, and patient information.

Systematic Review: Opioid Treatment for Chronic Back Pain: Prevalence, Efficacy, and Association with Addiction

Context Patients with low back pain often request pain medication, and many physicians prescribe opioids despite concerns about drug dependence. Contribution Opioid prescribing rates in 11 studies

A Systematic Review of Psychological Factors as Predictors of Chronicity/Disability in Prospective Cohorts of Low Back Pain

Study Design. A systematic review of prospective cohort studies in low back pain. Objectives. To evaluate the evidence implicating psychological factors in the development of chronicity in low back

Meta-Analysis: Exercise Therapy for Nonspecific Low Back Pain

TLDR
This meta-analysis summarizes data from 61 randomized, controlled trials that compared exercise therapy with placebo, no treatment, conservative management, or another exercise group to conclude that the evidence did not support effectiveness of exercises for acute low back pain but that exercises may be helpful for chronicLow back pain.

painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain

TLDR
Simple, patient-based, easy-to-use screening questionnaires can determine the prevalence of neuropathic pain components both in individual LBP patients and in heterogeneous cohorts of such patients.