Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society

  1. Roger Chou, MD;
  2. Amir Qaseem, MD, PhD, MHA;
  3. Vincenza Snow, MD;
  4. Donald Casey, MD, MPH, MBA;
  5. J. Thomas Cross, Jr, MD, MPH;
  6. Paul Shekelle, MD, PhD;
  7. Douglas K. Owens, MD, MS; and
  8. for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians and the American College of Physicians/American Pain Society Low Back Pain Guidelines Panel*
  1. From Oregon Health & Science University, Portland, Oregon; the American College of Physicians, Philadelphia, Pennsylvania; Atlantic Health, Morristown, New Jersey; Medstudy, Colorado Springs, Colorado; and Veterans Affairs Health Care System and RAND, Santa Monica, Veterans Affairs Palo Alto Health Care System, Palo Alto, and Stanford University, Stanford, California.
    1. Figure 1. ). Do not use this algorithm for back pain associated with major trauma, nonspinal back pain, or back pain due to systemic illness. CRP = C-reactive protein; EMG = electromyography; ESR = erythrocyte sedimentation rate; MRI = magnetic resonance imaging; NCV = nerve conduction velocity.
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        Figure 1. ). Do not use this algorithm for back pain associated with major trauma, nonspinal back pain, or back pain due to systemic illness. CRP = C-reactive protein; EMG = electromyography; ESR = erythrocyte sedimentation rate; MRI = magnetic resonance imaging; NCV = nerve conduction velocity. Initial evaluation of low back pain (LBP
      • Figure 2. ). MRI = magnetic resonance imaging; NSAIDs = nonsteroidal anti-inflammatory drugs; TCA = tricyclic antidepressants.
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          Figure 2. ). MRI = magnetic resonance imaging; NSAIDs = nonsteroidal anti-inflammatory drugs; TCA = tricyclic antidepressants. Management of low back pain (LBP

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        Summary for Patients

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