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

@article{Chou2007MedicationsFA,
  title={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},
  author={Roger Chou and Laurie Hoyt Huffman},
  journal={Annals of Internal Medicine},
  year={2007},
  volume={147},
  pages={505-514}
}
In the United States, low back pain is the fifth most common reason for all physician office visits and the second most common symptomatic reason (1, 2). Medications are the most frequently recommended intervention for low back pain (1, 3). In 1 study, 80% of primary care patients with low back pain were prescribed at least 1 medication at their initial office visit, and more than one third were prescribed 2 or more drugs (4). The most commonly prescribed medications for low back pain are… 
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References

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Medication Use for Low Back Pain in Primary Care
TLDR
Patients prescribed medications, particularly muscle relaxants, reported less severe symptoms after 1 week than those receiving no medications, and Medication use for back pain in this health maintenance organization was generally concordant with national guidelines.
Chronic Opioid Analgesic Therapy for Chronic Low Back Pain
TLDR
Recommendations were formulated for implementing chronic opioid analgesic therapy (COAT) for patients with chronic low back pain and case series reports suggest that COAT is safe and effective for many patients with recalcitrant chronicLow back pain.
Evidence for and against the use of opioid analgesics for chronic nonmalignant low back pain: a review.
TLDR
There is a place for the use of chronic oral or transdermal opioid analgesics in the treatment of some patients withCLBP, and the scant evidence that is available suggests that over the short-term, COAT is helpful with patients with CLBP.
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.
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.
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.
Nonsteroidal Anti-Inflammatory Drugs for Low Back Pain: A Systematic Review Within the Framework of the Cochrane Collaboration Back Review Group
TLDR
The evidence from the 51 trials included in this review suggests that nonsteroidal anti-inflammatory drugs are effective for short-term symptomatic relief in patients with acute low back pain and there does not seem to be a specific type of nonsteroid anti- inflammatory drug that is clearly more effective than others.
Tramadol/acetaminophen combination tablets for the treatment of chronic lower back pain: a multicenter, randomized, double-blind, placebo-controlled outpatient study.
TLDR
In this study, tramadol 37.5 mg/APAP 325 mg combination tablets were effective and had a favorable safety profile in the treatment of chronic lower back pain.
Non-steroidal anti-inflammatory drugs for low back pain.
TLDR
The evidence from the 51 trials included in this review suggests that NSAIDs are effective for short-term symptomatic relief in patients with acute low back pain, and there does not seem to be a specific type of NSAID which is clearly more effective than others.
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