Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline

@article{Chou2017NonpharmacologicTF,
  title={Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline},
  author={Roger Chou and Richard A. Deyo and Janna L Friedly and Andrea C. Skelly and Robin E. Hashimoto and Melissa B Weimer and Rochelle Fu and Tracy L Dana and Paul Kraegel and Jessica C. Griffin and Sara E. Grusing and Erika D. Brodt},
  journal={Annals of Internal Medicine},
  year={2017},
  volume={166},
  pages={493-505}
}
Low back pain is very common and is associated with more global disability than any other condition (1). Several nonpharmacologic, noninvasive therapies are available for low back pain, including exercise, complementary and alternative therapies (such as spinal manipulation, acupuncture, massage, and mindbody interventions), psychological therapies (such as cognitive behavioral and operant therapy), physical techniques (such as traction, ultrasound, transcutaneous electrical nerve stimulation… 
Systemic Pharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline
TLDR
The current evidence on benefits and harms of medications for low back pain is reviewed, including acetaminophen, NSAIDs, opioids, tramadol and tapentadol, antidepressants, skeletal muscle relaxants, benzodiazepines, corticosteroids, and antiseizure medications.
Acupuncture for the Management of Low Back Pain
TLDR
This evidence-based systematic review will focus on the use of acupuncture and its role in the treatment of low back pain to help better guide physicians in their practice and weigh the evidence that is available to support acupuncture as a treatment modality forLow back pain.
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians.
TLDR
Clinicians should only consider opioids as an option in patients who have failed the aforementioned treatments and only if the potential benefits outweigh the risks for individual patients and after a discussion of known risks and realistic benefits with patients.
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain
  • D. Marcus
  • Medicine
    Annals of Internal Medicine
  • 2017
TLDR
The guideline's compilation of many weakly effective, disparate therapies will do little to assist health care providers to make knowledgeable decisions or to inform such areas as insurance coverage, quality-of-care evaluations, and medicolegal liability standards.
Management of Low Back Pain: Getting From Evidence-Based Recommendations to High-Value Care
  • S. Atlas
  • Medicine
    Annals of Internal Medicine
  • 2017
This issue of Annals includes updated systematic reviews of noninvasive pharmacologic and nonpharmacologic therapies for low back pain and accompanying practice recommendations from the American
Nonpharmacologic and Pharmacologic Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries in Adults: A Clinical Guideline From the American College of Physicians and American Academy of Family Physicians
TLDR
This guideline is based on a systematic evidence review on the comparative efficacy and safety of nonpharmacologic and pharmacologic management of acute pain from non-low back, musculoskeletal injuries in adults in the outpatient setting and a systematic review of the predictors of prolonged opioid use.
Nonpharmacologic Therapies for Low Back Pain
TLDR
The trial results indicate that spinal manipulation may be more effective in treating chronic low back pain than Chou and colleagues (and, by extension, the American College of Physicians' guideline) report, and possible explanations include using physicians to provide spinal manipulation and adopting analytic approaches recommended by the National Institutes of Health Task Force.
Are Opioids Needed to Treat Chronic Low Back Pain? A Review of Treatment Options and Analgesics in Development
TLDR
There remains an unmet need for effective and tolerable opioid receptor agonists for the treatment of CLBP with improved safety properties over legacy opioids.
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain
TLDR
It is agreed that tramadol would probably not have been recommended as a treatment option for chronic low back pain and that future research and reporting should consider whether age or other factors should alter the primary approach to management.
Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions
TLDR
While there is a rightful role for analgesics in the management of LBP, nonpharmacological options should be seriously considered, as they can play an important and health-sustaining role in patient management.
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Systemic Pharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline
TLDR
The current evidence on benefits and harms of medications for low back pain is reviewed, including acetaminophen, NSAIDs, opioids, tramadol and tapentadol, antidepressants, skeletal muscle relaxants, benzodiazepines, corticosteroids, and antiseizure medications.
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