According to recent guidelines outlined by the American College of Physicians and the American Pain Society, doctors should not routinely order imaging or other diagnostic tests such as MRIs, CAT scans, or X-rays for patients with nonspecific low back pain.
This is good news for those who have nonspecific low back pain and may be facing MRIs or CAT scans to help determine the source of their pain. These tests can be quite uncomfortable for some and should be reserved for patients with severe or progressive neurological deficits or suspected underlying conditions such as infection or cancer.
The guidelines, which are published in the Oct. 2 issue of the journal Annals of Internal Medicine , include a method to guide primary care doctors and other clinicians in gathering and interpreting information during a patient’s first visit. This formula would place them in one of three general categories:
* Nonspecific low back pain, which affects about 85 percent of patients.
* Back pain potentially associated with spinal conditions, such as spinal stenosis, sciatica, or
vertebral compression fracture.
* Back pain potentially associated with another specific cause, such as cancer.
Though drugs are often used to treat chronic and acute low back pain, it should be noted that they’re not always effective.
“Almost all medications reviewed had some benefits, but they have risks,” guidelines co-author Roger Chou, head of the American Pain Society Clinical Practice Guidelines Program, said in a prepared statement. “Acetaminophen, for example, is very safe but might not be effective. NSAIDs have gastrointestinal and cardiovascular risks. Opioids and muscle relaxers can provide relief for those with severe pain, but their potential benefits and risks should be weighed carefully.”
Instead, alternative Chou reccommends acupuncture, spinal manipulations and massage therapy as useful modalities to treat the pain. Te benefits are that these alternative therapies can be utilized long term with historically little or no side effects.