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1. Back pain - low (without radiculopathy): How should I diagnose the cause of low back pain?

Back pain - low (without radiculopathy): How should I diagnose the cause of low back pain? Diagnosis | Diagnosis | Back pain - low (without radiculopathy) | CKS | NICE Search CKS… Menu Diagnosis Back pain - low (without radiculopathy): How should I diagnose the cause of low back pain? Last revised in November 2018 How should I diagnose the cause of low back pain? Assess the person. Ask about the type of pain, duration of symptoms, aggravating and relieving factors, associated symptoms (...) , radiation of pain, night pain. Examine the person. Observe gait, posture, skin and any bruising, skin changes, rashes, deformity or swelling of the back. Perform a neurological examination looking for loss of sensation, changes to reflexes, limitation of range of movement including straight leg raising, tenderness, fever and loss of anal tone. Assess for the presence of that may suggest a serious underlying cause, such as: Cauda equina syndrome. Cancer of the spine. Spinal fracture due to trauma

2018 NICE Clinical Knowledge Summaries

2. Use of back belts to prevent occupational low-back pain

Use of back belts to prevent occupational low-back pain Use of back belts to prevent occupational low-back pain | CMAJ Main menu User menu Search Search for this keyword Search for this keyword Practice Use of back belts to prevent occupational low-back pain Recommendation statement from the Canadian Task Force on Preventive Health Care Recommendation The Canadian Task Force on Preventive Health Care concludes that the existing evidence is conflicting and does not allow the task force to make (...) a recommendation for or against the use of back belts to either prevent occupational low-back pain or to reduce lost work time due to occupational low-back pain (grade C recommendation). In Canada, back injuries account for over 25% of all lost time claims, the largest single claims category in most workers' compensation jurisdictions. Low-back pain (LBP), which is often seen initially in primary care practice, is estimated to be the most costly ailment in working-age adults. Disability resulting from LBP

2003 CPG Infobase

3. Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines Background: Regenerative medicine is a medical subspecialty that seeks to recruit and enhance the body’s own inherent healing armamentarium in the treatment of patient pathology. This therapy’s intention is to assist in the repair, and to potentially replace or restore damaged tissue through the use of autologous or allogenic biologics (...) evidence regarding the use of medicinal signaling/ mesenchymal stem cell (MSCs) with a high-quality RCT, multiple moderate-quality observational studies, a single-arm meta-analysis, and 2 systematic reviews, the qualitative evidence has been assessed as Level III (on a scale of Level I through V) using a qualitative modified approach to the grading of evidence based Guidelines Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain

2019 American Society of Interventional Pain Physicians

4. Interventional Therapies, Surgery, and Interdisciplinary Rehabilitation for Low Back Pain

Interventional Therapies, Surgery, and Interdisciplinary Rehabilitation for Low Back Pain Interventional Therapies, Surgery, and Interdisciplinary Reh... : Spine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer Register for a free account Registered users can save articles (...) your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection doi: 10.1097/BRS.0b013e3181a1390d Literature Review Buy Study Design. Clinical practice guideline . Objective. To develop evidence-based recommendations on use of interventional diagnostic tests and therapies, surgeries, and interdisciplinary rehabilitation for low back pain of any duration, with or without leg pain. Summary of Background Data. Management of patients with persistent

2009 Publication 1228

5. Diagnosis and Treatment of Low Back Pain

Diagnosis and Treatment of Low Back Pain Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis & Treatment of Low Back Pain 7075 Veterans Blvd Burr Ridge, IL 60527 630-230-3600 www.spine.org © 2020 North American Spine Society 978-1-929988-65-5Diagnosis & Treatment of Low Back Pain | Preface Recommendations were developed based on a specific definition, inclusion/exclusion criteria, and the resulting literature which excluded conditions such as presence (...) of a neurological deficit or leg pain experienced below the knee, among others. Given the exclusion criteria, these guideline rec- ommendations address a subset of low back pain care as opposed to low back pain in its entirety. This clinical guideline is not intended to be a fixed treatment protocol; it is anticipated that there will be patients who require more or less treatment than what is outlined. This clinical guideline should not be construed as including all proper methods of care or excluding other

2020 North American Spine Society

6. Low Back Pain

Low Back Pain EVIDENCE-INFORMED PRIMARY CARE MANAGEMENT OF LOW BACK PAIN Clinical Practice Guideline | December 2015 These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They should be used as an adjunct to sound clinical decision-making. OBJECTIVE To help Alberta clinicians make evidence-informed decisions about care of patients with non- specific low back pain TARGET (...) POPULATION Adult patients 18 years or older in primary care settings EXCLUSIONS Pregnant women; patients under the age of 18 years; diagnosis or treatment of specific causes of low back pain such as: surgical conditions including instability; referred pain (from abdomen, kidney, ovary, pelvis, bladder); inflammatory conditions (rheumatoid arthritis, ankylosing spondylitis); infections (discitis, osteomyelitis, epidural abscess); degenerative and structural changes (spondylosis, spondylolisthesis, gross

2017 Accelerating Change Transformation Team

7. Back pain - low (without radiculopathy): Weak opioids

Back pain - low (without radiculopathy): Weak opioids Weak opioids | Prescribing information | Back pain - low (without radiculopathy) | CKS | NICE Search CKS… Menu Weak opioids Back pain - low (without radiculopathy): Weak opioids Last revised in November 2018 Weak opioids For detailed information on prescribing a weak opioid, see the CKS topic on . © .

2018 NICE Clinical Knowledge Summaries

8. Back pain - low (without radiculopathy): Red flag symptoms and signs

Back pain - low (without radiculopathy): Red flag symptoms and signs Red flag symptoms and signs | Diagnosis | Back pain - low (without radiculopathy) | CKS | NICE Search CKS… Menu Red flag symptoms and signs Back pain - low (without radiculopathy): Red flag symptoms and signs Last revised in November 2018 Red flag symptoms and signs Serious conditions whose signs and symptoms can cause low back pain are listed below. Cauda equina syndrome . Red flags include: Severe or progressive bilateral (...) years of age or more. Gradual onset of symptoms. Severe unremitting pain that remains when the person is supine, aching night pain that prevents or disturbs sleep, pain aggravated by straining (for example, at stool, or when coughing or sneezing), and thoracic pain. Localised spinal tenderness. No symptomatic improvement after four to six weeks of conservative low back pain therapy. Unexplained weight loss. Past history of cancer — breast, lung, gastrointestinal, prostate, renal, and thyroid cancers

2018 NICE Clinical Knowledge Summaries

9. Back pain - low (without radiculopathy): Paracetamol

Back pain - low (without radiculopathy): Paracetamol Paracetamol | Prescribing information | Back pain - low (without radiculopathy) | CKS | NICE Search CKS… Menu Paracetamol Back pain - low (without radiculopathy): Paracetamol Last revised in November 2018 Paracetamol For detailed information on prescribing paracetamol, see the CKS topic on . © .

2018 NICE Clinical Knowledge Summaries

10. Back pain - low (without radiculopathy): Scenario: Management

Back pain - low (without radiculopathy): Scenario: Management Scenario: Management | Management | Back pain - low (without radiculopathy) | CKS | NICE Search CKS… Menu Scenario: Management Back pain - low (without radiculopathy): Scenario: Management Last revised in November 2018 Scenario: Management From age 16 years onwards. How should I manage a person with low back pain? If there are that may suggest a serious underlying cause, admit or refer urgently for specialist assessment, or imaging (...) , using clinical judgement. If an for the low back pain has been identified, manage according to the specific diagnosis. If non-specific low back pain is suspected, assess the person using a risk stratification tool such as to identify modifiable risk factors (biomedical, psychological and social) for back pain disability. Quality of life, pain severity, function, and psychological distress are the most important factors to guide the person's management. People with low back pain who are likely

2018 NICE Clinical Knowledge Summaries

11. Back pain - low (without radiculopathy): Nonsteroidal anti-inflammatory drugs

Back pain - low (without radiculopathy): Nonsteroidal anti-inflammatory drugs Nonsteroidal anti-inflammatory drugs | Prescribing information | Back pain - low (without radiculopathy) | CKS | NICE Search CKS… Menu Nonsteroidal anti-inflammatory drugs Back pain - low (without radiculopathy): Nonsteroidal anti-inflammatory drugs Last revised in November 2018 Nonsteroidal anti-inflammatory drugs For detailed information on prescribing a nonsteroidal anti-inflammatory drug (NSAID), see the CKS

2018 NICE Clinical Knowledge Summaries

12. Back pain - low (without radiculopathy): Diazepam

Back pain - low (without radiculopathy): Diazepam Diazepam | Prescribing information | Back pain - low (without radiculopathy) | CKS | NICE Search CKS… Menu Diazepam Back pain - low (without radiculopathy): Diazepam Last revised in November 2018 Diazepam Dosing information Dosing information Initially prescribe diazepam 2 mg up to three times a day when required to relieve muscle spasm. If necessary, the dose can be titrated up to 5 mg three times a day. A short course (2–5 days

2018 NICE Clinical Knowledge Summaries

13. Back pain - low (without radiculopathy)

Back pain - low (without radiculopathy) Back pain - low (without radiculopathy) | Topics A to Z | CKS | NICE Search CKS… Menu Back pain - low (without radiculopathy) Back pain - low (without radiculopathy) Last revised in November 2018 Low back pain affects the lumbosacral area of the back, between the bottom of the ribs and the top of the legs. Diagnosis Management Prescribing information Background information Back pain - low (without radiculopathy): Summary Low back pain affects (...) the lumbosacral area of the back, between the bottom of the ribs and the top of the legs. It affects around one third of the adult population each month. In most people, low back pain is non-specific and serious specific causes are rare. Complications include: Development of chronicity and depression. Disability and loss of employment. Non-specific low back pain is often a chronic problem in which periods of little pain or disability are interrupted by acute episodes of severe pain. In people with low back

2019 NICE Clinical Knowledge Summaries

14. Diagnosis and Treatment of Low Back Pain

Diagnosis and Treatment of Low Back Pain Low Back Pain -- Clinical Recommendation Welcome Search Search Specify your search AAFP.org Patient Care Clinical Practice Guideline Low Back Pain Diagnosis and Treatment of Low Back Pain (Endorsed, April 2017) The guideline, Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain , was developed by the American College of Physicians and was endorsed by the American Academy of Family Physicians. Key Recommendations Nonpharmacologic (...) treatment, including superficial heat, massage, acupuncture, or spinal manipulation, should be used initially for most patients with acute or subacute low back pain, as they will improve over time regardless of treatment. When pharmacologic treatment is desired, nonsteroidal anti-inflammatory drugs (NSAIDs) or skeletal muscle relaxants should be used. Nonpharmacologic treatment, including exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor

2017 American Academy of Family Physicians

15. Low Back Pain

Low Back Pain Date of origin: 1996 Last review date: 2015 ACR Appropriateness Criteria ® 1 Low Back Pain American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Low Back Pain Variant 1: Acute, subacute, or chronic uncomplicated low back pain or radiculopathy. No red flags. No prior management. Radiologic Procedure Rating Comments RRL* MRI lumbar spine without IV contrast 2 O X-ray lumbar spine 2 ??? CT myelography lumbar spine 2 ???? Tc-99m bone scan with SPECT spine 2 (...) If there is concern for spondylolysis in a young patient, SPECT/CT remains the gold standard. ??? CT lumbar spine without IV contrast 2 ??? CT lumbar spine with IV contrast 2 ??? MRI lumbar spine without and with IV contrast 2 O CT lumbar spine without and with IV contrast 1 ???? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Low Back Pain Clinical Condition: Low Back Pain Variant 2: Acute, subacute

2015 American College of Radiology

16. Low Back Pain, Adult Acute and Subacute

Low Back Pain, Adult Acute and Subacute Guidelines | ICSI The MN Health Collaborative includes physicians and other representatives from major healthcare organizations working together to address major health topics affecting Minnesota communities today. ICSI has been developing evidence-based clinical practice guidelines to improve patient care since 1993. ICSI helps forward-focused Minnesota health organizations find ways to redefine and redesign systems and the market. Together, we aim (...) College of Cardiology (ACC)/American Heart Association (AHA). March 29, 2018 "/> Adult patients age 18 and over in primary care who have symptoms of low back pain or radiculopathy. The focus is on the acute (pain for up to 7 weeks) and subacute (pain for between 7 and 12 weeks) phases of low back pain. It includes the ongoing management, including indications for spine specialist referral within the first 12 weeks of onset. July 27, 2017 "/> This guideline is targeted toward identification of adult

2017 Institute for Clinical Systems Improvement

17. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians

Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain | Annals of Internal Medicine | American College of Physicians '); } Sign in below to access your subscription for full content INDIVIDUAL SIGN IN | You will be directed to acponline.org to register and create your Annals account INSTITUTIONAL SIGN IN | | Subscribe to Annals of Internal (...) Medicine . You will be directed to acponline.org to complete your purchase. Search Clinical Guidelines | 4 April 2017 Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians Free Amir Qaseem, MD, PhD, MHA; Timothy J. Wilt, MD, MPH; Robert M. McLean, MD; Mary Ann Forciea, MD; for the Clinical Guidelines Committee of the American College of Physicians Amir Qaseem, MD, PhD, MHA From the American College of Physicians

2017 American College of Physicians

18. Back Pain ? Child

Back Pain ? Child New2016 ACR Appropriateness Criteria ® 1 Back Pain–Child American College of Radiology ACR Appropriateness Criteria ® Back Pain–Child Variant 1: Child. Back pain with none of the following clinical red flags: constant pain, night pain, radicular pain, pain lasting >4 weeks, abnormal neurologic examination. Initial imaging evaluation. Radiologic Procedure Rating Comments RRL* X-ray spine area of interest 2 See references [1,4-6,8,9,11,12,21]. Varies MRI complete spine without (...) ; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Back Pain–Child Variant 2: Child. Back pain with 1 or more of the following clinical red flags: constant pain, night pain, radicular pain, pain lasting >4 weeks, abnormal neurologic examination. Initial imaging evaluation. Radiologic Procedure Rating Comments RRL* X-ray spine area of interest 8 See references [1,4-6,9]. Varies MRI complete spine without IV contrast 5 This procedure may be appropriate

2016 American College of Radiology

19. Chronic Back Pain: Suspected Sacroiliitis/Spondyloarthropathy

Chronic Back Pain: Suspected Sacroiliitis/Spondyloarthropathy Date of origin: 2016 ACR Appropriateness Criteria ® 1 Chronic Back Pain American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Chronic Back Pain: Suspected Sacroiliitis/Spondyloarthropathy Variant 1: Inflammatory sacroiliac or back symptoms. Suspected axial spondyloarthropathy. Initial evaluation. Radiologic Procedure Rating Comments RRL* X-ray sacroiliac joints 9 ?? X-ray spine 9 Complementary examination (...) with SPECT spine 1 ??? FDG-PET CT whole body 1 ???? US sacroiliac joints 1 O Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Chronic Back Pain Clinical Condition: Chronic Back Pain: Suspected Sacroiliitis/Spondyloarthropathy Variant 2: Inflammatory sacroiliac symptoms. Suspected axial spondyloarthropathy. Radiographs negative or equivocal. Radiologic Procedure Rating Comments RRL* MRI sacroiliac

2016 American College of Radiology

20. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 13: Injection therapies, low-back pain, and lumbar fusion

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 13: Injection therapies, low-back pain, and lumbar fusion J Neurosurg Spine 21:79–90, 2014 79 ©AANS, 2014 J Neurosurg: Spine / Volume 21 / July 2014 Therapeutic Recommendations There is no new evidence that conflicts with the pre - vious recommendations regarding injection therapies pub- lished in the original version of the “Guidelines for the per - formance of fusion procedures (...) for degenerative disease of the lumbar spine.” 27 Lumbar Epidural Steroid Injections Grade C Lumbar epidural steroid injections (ESIs) are an op- tion for the short-term relief of chronic low-back pain without radiculopathy in patients with degenerative dis- ease of the lumbar spine (Level III evidence). Caudal ESIs are an option for decreasing low-back pain of greater than 6 weeks’ duration, without radiculop - athy, in patients with degenerative disease of the lumbar spine (Level III evidence). Lumbar Facet

2014 Congress of Neurological Surgeons

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