- Nonpharmacologic therapies should be used as first-line treatments for acute (<4 wk), subacute (4-12 wk), and chronic (>12 wk) low back pain.
- If nonpharmacologic therapies do not work, then NSAIDs are the first-line pharmacologic therapies.
- Acetaminophen is ineffective at relieving low back pain.
Why this matters
- Around 25% of US adults report low back pain lasting at least 1 d in the prior 3 mo.
- The American College of Physicians (ACP) conducted 2 evidence-based reviews of randomized controlled trials.
- The reviews served as a springboard for the clinical practice guideline and a video message from the ACP President.
- Funding: Source undisclosed.
Acute and subacute low back pain
- Most patients will improve over time irrespective of treatment.
- First-line nonpharmacologic therapies include massage, superficial heat, acupuncture, or spinal manipulation.
- NSAIDs or skeletal muscle relaxants should be used if pharmacologic treatment is preferred.
Chronic low back pa...4>