New Guidelines for Diagnosing and Treating Low Back Pain

If you are one of the millions of Americans who suffer from low back pain, some new recommendations may help your treatment. The American College of Physicians (ACP), the nation’s largest medical specialty organization, and the American Pain Society (APS) have issued joint guidelines for treating and diagnosing low back pain. One of the key recommendations is that clinicians should not routinely order imaging tests such as X-rays, CT scans, or MRIs for patients with nonspecific pain since there is no evidence they improve patient outcomes. However, for patients with some serious underlying neurological disorder, or some serious underlying disease, these imaging studies might be appropriate.The new guidelines provide evidence-based information to doctors to diagnose and manage the pain. They are important for physicians to categorize back pain as musculoskeletal, associated with nerve damage, or related to another serious condition, which helps subsequent management. Almost all medications reviewed had some benefits in treatment, but they also have risks that need to be considered. The guidelines also say that patients can benefit from non-drug treatments, such as acupuncture, spinal manipulation, and massage therapy. None of these, however, were proven to be more effective than others to warrant recommendation as first-line therapy. The joint ACP-APS guidelines are designed for primary care physicians and other clinicians and do not address invasive therapies, such as surgery.