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New guidelines for lower back pain


Published: Oct. 3, 2007 at 4:58 PM
PORTLAND, Ore., Oct. 3 (UPI) -- New guidelines for doctors treating lower back pain issued by two U.S. medical societies advise considering non-drug treatments.

These treatments, which are to be considered if self-care and medication are not working, include supervised exercise therapy, chiropractic care and massage therapy.

The American Pain Society and American College of Physicians compiled the guidelines for primary care settings, published in the Annals of Internal Medicine, after an analysis of published research conducted at the Oregon Evidence-Based Practice Center at Oregon Health & Science University.

"Some medications offer some benefits for low-back pain but they have risks," guidelines co-author Dr. Roger Chou said in a statement. "For example, acetaminophen is safe but not that effective, NSAIDs -- non-steroidal anti-inflammatory drugs -- like ibuprofen provide more relief but have gastrointestinal and cardiovascular side effects and opioids can treat severe pain but pose risks for sedation and dependence over time."

Physicians and patients should discuss proven options and select the ones that best suit their specific needs, suggested Chou.

The guidelines advise against imaging tests for patients with non-specific low-back pain because they are not helpful and could result in excessive radiation exposure or unnecessary procedures, Chou said.

"That said, clinicians should order diagnostic imaging tests for patients known or believed to have underlying neurological or spinal disorders," Chou added.



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