Medication Use for Low Back Pain in Primary Care

@article{Cherkin1998MedicationUF,
  title={Medication Use for Low Back Pain in Primary Care},
  author={Daniel C. Cherkin and Kimberly J. Wheeler and William E. Barlow and Richard A. Deyo},
  journal={Spine},
  year={1998},
  volume={23},
  pages={607–614}
}
Study Design. A longitudinal observational study of primary care patients with low back pain. Objectives. 1) To describe medications prescribed for back pain, 2) to identify patient characteristics associated with type of drug therapy, 3) to determine if the prescription of certain drugs is associated with better outcomes, and 4) to compare physician prescribing behavior with national guidelines. Summary of Background Data. Few previous studies have focused on medication prescribing patterns… 
The Use of Muscle Relaxant Medications in Acute Low Back Pain
TLDR
Over time, among patients with greater functional status impairment at baseline, muscle relaxant users had somewhat slower recovery from the episode of back pain, and this finding persisted after controlling for baseline functional status, age, worker’s compensation status, and use of nonsteroidal inflammatory agents.
Analgesic use in older adults with back pain: the BACE study.
TLDR
In these older adults consulting their GP with back pain, 72% used analgesics at baseline, and despite a decrease in medication use during follow-up, at 3 and 6 months a considerable proportion still used analgesICS.
Analgesic Usage for Low Back Pain: Impact on Health Care Costs and Service Use
TLDR
Patients with LBP with and without neurologic involvement and those with acquired lumbar spine structural disorders had similar patterns of analgesic use: those with congenital structural disorders were less likely to use analgesics; andThose with psychogenic pain and LBP related to orthopedic devices were more likely toUse opioids.
Variability in prescribing for musculoskeletal pain in Finnish primary health care
TLDR
NSAIDs are the prevailing treatment for musculoskeletal pain in Finnish primary health care and there was a large variation in prescribing patterns between individual physicians and between different areas of the country.
Satisfaction as a Predictor of Clinical Outcomes Among Chiropractic and Medical Patients Enrolled in the UCLA Low Back Pain Study
TLDR
Perception of improvement was greater among highly satisfied than less satisfied patients throughout the 18-month follow-up period and the estimated effects of satisfaction on clinical outcomes were similar for medical and chiropractic patients.
Pharmacological Management of Low Back Pain
TLDR
When choosing medications for treatment of low back pain, practice guidelines provide a useful starting point for making decisions, but clinicians should base therapeutic choices on individualized consideration and discussion with patients regarding the potential benefits and risks.
Pharmacoeconomic Analysis of Pain Medications Used to Treat Adult Patients with Chronic Back Pain in the United States
TLDR
NSAIDs are found to be a dominant strategy as compared with opioids in chronic back pain patients and it might be cost-effective if they are used in patients who did not respond to the NSAIDs.
Narcotic drug use among patients with lower back pain in employer health plans: a retrospective analysis of risk factors and health care services.
TLDR
This retrospective study examines the risk factors of narcotic drug use, medical and pharmacy claim costs, and health services use among lower back pain (LBP) patients who use narcotic medications and found subjects with LBP who used Narcotic medications were more likely to have additional coexisting health conditions and used more health care services.
Classification of Low Back Pain in Primary Care: Using “Bothersomeness” to Identify the Most Severe Cases
TLDR
There is evidence for the validity of a single bothersomeness question as a measure of LBP severity and it has the potential to provide a practical standard scheme for classifying patients with LBP in clinical practice.
Medications for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline
TLDR
Current evidence on benefits and harms of medications for acute and chronicLow back pain is reviewed as part of a larger evidence review commissioned by the American Pain Society and the American College of Physicians to guide recommendations for management of low back pain.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 16 REFERENCES
Predicting Poor Outcomes for Back Pain Seen in Primary Care Using Patients' Own Criteria
TLDR
The proportion of primary care patients with back pain who have poor outcomes appears to be higher than generally recognized and ways of improving how primary care responds to patients with persisting pain should be investigated.
Pitfalls of Patient Education: Limited Success of a Program for Back Pain in Primary Care
TLDR
These findings challenge the value of purely educational approaches in reducing functional impact or health care use related to back pain and also challenge thevalue of fitness exercise in the most acute phase of back pain.
Back pain in primary care. Outcomes at 1 year.
TLDR
The outcome of back pain was predicted by pain- related disability and days in pain rather than by recency of onset, so it may be more meaningful to distinguish characteristic levels of pain intensity, pain-related disability, and pain persistence than to classify patients as acute or chronic.
Drug Therapy for Back Pain: Which Drugs Help Which Patients?
TLDR
There is good evidence to support the efficacy of nonsteroidal anti‐inflammatory drugs for acute low back pain and fair evidence for the use of muscle relaxants and narcotic analgesics.
Physician Office Visits for Low Back Pain: Frequency, Clinical Evaluation, and Treatment Patterns From a U.S. National Survey
TLDR
The frequency of office visits for low back pain, the content of ambulatory care, and how these vary by physician specialty are characterized and visit, referral, and management patterns among specialties providing the most care are described.
Do antidepressant medications relieve chronic low back pain?
TLDR
The literature has not demonstrated that antidepressants are superior to placebos in improving low back pain or related problems, and further randomized controlled trials are needed to determine whether antidepressants are useful forLow back pain.
Assessing Health‐Related Quality of Life in Patients With Sciatica
TLDR
These measures performed well in measuring the health-related quality-of-life of patients with sciatica, and the modified Roland and the physical dimension of the SF-36 were the measures most responsive to change over time, suggesting their use in prospective evaluation.
Good Prognosis for Low Back Pain When Left Untampered: A Randomized Clinical Trial
TLDR
This study indicates that low back pain treated as a benign, self limiting condition recommended to light mobilization gives superior results as compared to treatment within a conventional medical system.
Lengthy bed rest prescribed for acute low back pain: experience at three general medicine walk-in clinics.
TLDR
Early gradual ambulation is currently recommended for patients with acute low back pain if results of neurologic examination are normal, and bed rest for up to 2 days is considered optimal, but most patients were advised to rest in bed longer than 2 days.
...
1
2
...