Information on Low Back Pain from the National Institute of Neurological Disorders and Stroke (NIH)
If you have lower back pain, you are not alone. Nearly everyone at some point has back pain that interferes with work, routine daily activities, or recreation. Americans spend at least $50 billion each year on low back pain, the most common cause of job-related disability and a leading contributor to missed work. Back pain is the second most common neurological ailment in the United States — only headache is more common. Read more at the National Institute of Neurological Disorders and Stroke, National Institutes of Health.
Information on Low Back Pain from the University of Pittsburgh Medical Center (UMPC)
Low back pain is an ache or discomfort in the area of the lower part of the back and spinal column. The lower spinal column consists of many small bones that surround and protect the spinal cord and nerves. Low back pain is very common, affecting most adults at some point in their lives. Read more from UPMC.
Information on Back Pain from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health
Back pain is an all-too-familiar problem that can range from a dull, constant ache to a sudden, sharp pain that leaves you incapacitated. It can come on suddenly—from an accident, a fall, or lifting something heavy—or it can develop slowly, perhaps as the result of age-related changes to the spine. Regardless of how back pain happens or how it feels, you know it when you have it. And chances are, if you don’t have back pain now, you will eventually. Read more at the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health.
Interactive Quiz: Low Back Pain
Low back pain interferes with work, daily activities, and physical activity. Four out of five adults will experience some level of low back pain during their lifetime. Take this true/false quiz, provided by the Medical University of South Carolina, with eight questions to see how much you know about low back pain.
Interactive Tutorial: Back Exercises
Back pain is one of the most common medical problems in the U.S. It affects most people at least once in their lifetimes. If not taken seriously, back pain can last for a long period of time, and can become disabling. This tutorial, presented by the National Library of Medicine, National Institutes of Health, descibes back exercises you can do. The tutorial reviews the commons casues of back pain and back injury prevention tips.
Interactive Tutorial: How To Prevent Back Pain
This patient education module will help you understand the anatomy of the back, the most common causes of back pain, and measures you camn take to prevent back pain. To learn more, take the interactive tutorial, provided by National Library of Medicine, National Institutes of Health.
Online Tool: Back Pain Tracker
When you visit the doctor, it can be helpful to have a record of your back pain. This diary will help you track the frequency and intensity of your pain. And it may reveal a pattern that will help you and your doctor identify a successful treatment plan. Use this tool, provided by Back.com.
Podcast: Low Back Discomfort
Dr. Nancey Tsai, a physical health and rehabilitation specialist, describes causes of back pain and discusses options for treatment in cases not requiring surgery. She also makes recommendations for preventive methods of back strengthening. Additionally, Dr. Tsai talks about her standards for prescribing pain medication and offers her opinion on chiropractic work for treating back pain. Listen to the podcast, provided by the Medical University of South Carolina.
Video: Low Back Pain
Learn about lower back pain in this animation - both mechanical and compressive pain. Watch the video, provided by the Medical University of South Carolina.
Podcast: Low Back Pain
In this episode, Karyn Rahn, MD, explains potential causes and cures for low back pain. Listen to the podcast, provided by DukeHealth.org.
Podcast: Acupuncture Helps Ease Back Pain
Acupuncture certainly isn't a cure-all. But there is gathering evidence to suggest that it can be beneficial. The latest study, sponsored by the National Institutes of Health, finds that a seven-week course of acupuncture helped many patients ease the pain of chronic lower back pain. The study is published in the Archives of Internal Medicine. Listen to the podcast at npr.org.
Video: MSU unveils new approach to treating low back pain
Jacek Cholewicki, professor of Osteopathic Surgical Specialties at Michigan State University, discusses his spinal research and his method, borrowed from engineering, of spine systems science. Watch the video, provided by Michigan State University.
Video: What appears to cause low back pain in some people to become chronic?
MayoClinic.com lower back pain video.
Video: Back Pain
We asked Philip Sell, consultant orthopaedic and spinal surgeon, what he would want to know if he was suffering from back pain. Watch this video from the National Health Service, England.
Adult low back pain
A conservative approach should be first-line treatment. Emphasize patient education and conservative home self-care, which includes limited bed rest, early ambulation, postural advice, resumption of light-duty activities, use of ice and heat, anti-inflammatory and analgesic over-the-counter medications, and early return to work or activities. See National Guideline Clearinghouse major recommendations.
ACR Appropriateness Criteria low back pain
It is now clear from the above studies and others that uncomplicated acute LBP or radiculopathy is a benign, self-limited condition that does not warrant any imaging studies. The vast majority of these patients are back to their usual activities within 30 days. The challenge for the clinician, therefore, is to distinguish that small segment within this large patient population that should be evaluated further because of suspicion of a more serious problem. See National Guideline Clearinghouse major recommendations
Management of acute low back pain
Adults with low back pain or back-related leg symptoms for < 6 weeks. Patients with low risk of serious pathology (no red flags). Assessment to identify potential serious pathology. See National Guideline Clearinghouse major recommendations.
Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society
Clinicians should conduct a focused history and physical examination to help place patients with low back pain into 1 of 3 broad categories: nonspecific low back pain, back pain potentially associated with radiculopathy or spinal stenosis, or back pain potentially associated with another specific spinal cause. See National Guideline Clearinghouse major recommendations.
Management of chronic low back pain
Treatment for chronic low back pain (pain persisting for over 3 months) falls into three broad categories: monotherapies, mulitidisciplinary therapy, and reductionism. Full text available free through Pubmed.
A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain
The effect of osteopathic manual therapy (i.e., spinal manipulation) in patients with chronic and subchronic back pain is largely unknown, and its use in such patients is controversial. We performed a randomized, controlled trial that involved patients who had had back pain for at least three weeks but less than six months. Conclusions: Osteopathic manual care and standard medical care have similar clinical results in patients with subacute low back pain. Full text available free through the New England Journal of Medicine.
Meta-analysis: acupuncture for low back pain
BACKGROUND: Low back pain limits activity and is the second most frequent reason for physician visits. Previous research shows widespread use of acupuncture for low back pain. PURPOSE: To assess acupuncture's effectiveness for treating low back pain. CONCLUSIONS: Acupuncture effectively relieves chronic low back pain. No evidence suggests that acupuncture is more effective than other active therapies. Full text available free through Pubmed.
Non-steroidal anti-inflammatory drugs for low back pain
The evidence from the 65 trials included in this review suggests that NSAIDs are effective for short-term symptomatic relief in patients with acute and chronic low-back pain without sciatica. However, effect sizes are small. Furthermore, there does not seem to be a specific type of NSAID which is clearly more effective than others. The selective COX-2 inhibitors showed fewer side effects compared to traditional NSAIDs in the RCTs included in this review. However, recent studies have shown that COX-2 inhibitors are associated with increased cardiovascular risks in specific patient populations. Abstract available from Cochrane Reviews
Meta-analysis: exercise therapy for nonspecific low back pain
BACKGROUND: Exercise therapy is widely used as an intervention in low back pain. OBJECTIVE: To evaluate the effectiveness of exercise therapy in adult nonspecific acute, subacute, and chronic low back pain versus no treatment and other conservative treatments. Exercise therapy seems to be slightly effective at decreasing pain and improving function in adults with chronic low back pain, particularly in health care populations. In subacute low back pain populations, some evidence suggests that a graded-activity program improves absenteeism outcomes, although evidence for other types of exercise is unclear. In acute low back pain populations, exercise therapy is as effective as either no treatment or other conservative treatments. Full text available free through Pubmed.
Superficial heat or cold for low back pain
There is moderate evidence that heat wrap therapy reduces pain and disability for patients with back pain that lasts for less than three months. The relief has only been shown to occur for a short time and the effect is relatively small. The addition of exercise to heat wrap therapy appears to provide additional benefit. There is still not enough evidence about the effect of the application of cold for low-back pain of any duration, or for heat for back pain that lasts longer than three months. Abstract available from Cochrane Reviews.
Bed rest for acute low-back pain and sciatica
People with acute low-back pain who are advised to rest in bed have more pain and are less able to perform every day activities, on average, than those who are advised to stay active. As many people get some relief from low back pain and sciatica (pain down the back and leg) by lying down, bed rest is often recommended. However, this review found that, for people with acute low-back pain, advice to rest in bed is less effective in reducing pain and improving an individual's ability to perform every day activities than advice to stay active. Abstract available from Cochrane Reviews.
Massage for low-back pain
Massage might be beneficial for patients with subacute and chronic non-specific low-back pain, especially when combined with exercises and education. The evidence suggests that acupuncture massage is more effective than classic massage, but this need confirmation. More studies are needed to confirm these conclusions, to assess the impact of massage on return-to-work, and to determine cost-effectiveness of massage as an intervention for low-back pain. Abstract available from Cochrane Reviews.
Traction for low-back pain with or without sciatica
The results of the available studies involving mixed groups of acute, sub-acute and chronic patients with LBP with and without sciatica were quite consistent, indicating that continuous or intermittent traction as a single treatment for LBP is not likely effective for this group. Abstract available from Cochrane Reviews.
Does lumbar surgery for chronic low-back pain make a difference?
For patients who have had chronic low-back pain for at least 12 months and who are considered candidates for surgical stabilization of the lumbar spine, does surgery lead to better patient outcomes (as measured by the Oswestry disability index) than intensive rehabilitation? Lumbar fusion surgery in patients with chronic low-back pain does not appear to offer any major benefit in outcomes over conservative rehabilitation programs incorporating physical activity and cognitive–behavioural therapy. Full text available free through Pubmed.
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