Treatment Algorithm For Low Back Pain
2 2 low back pain 2 2 1 diagnosis figure 2 illustrates a diagnostic algorithmic ap proach for chronic low back pain without disc hernia tion.
Treatment algorithm for low back pain. Each year fewer than 5 of the patients who have an episode of low back pain. In the specific low back pain are classified all diseases whose etiology is well defined quick and accurate diagnosis is required for specific treatment. Acute low back pain is one of the most common reasons for adults to see a family physician.
Diagnosis and treatment of low back pain. Chronic low back pain pain. Beyond neuropathic pain snris have been shown to be effective in osteoarthritis chronic low back pain fibromyalgia and depression.
Gail lieb baltimore vamc chronic back pain management algorithm evaluation by primary care provider including x ray cat scan mri emg etc as indicated. The total costs of low back pain in the united states exceed 100 billion per year. Systematic review of 14 rcts nine looking at duloxetine and five at venlafaxine demonstrated a combined nnt of 6 4 5 2 8 4 and an nnh of 11 8 9 5 15 2.
Although most patients recover quickly with minimal treatment proper evaluation is imperative to. Lasting greater than 12 weeks is a leading cause of disability and cost. A subscription is required to access all the content in best practice.
Two thirds of these costs are indirect due to lost wages and reduced productivity. Treatment based classification tbc approach to low back pain describes the model whereby the clinician makes treatment decisions based on the patient s clinical presentation the primary purpose of the tbc approach is to identify features at baseline that predict responsiveness to four different treatment strategies. Studies have shown that tricyclic antidepressants e g amitriptyline produced symptom reduction whereas selective serotonin reuptake inhibitors did not.
Systematic review of antidepressants in the treatment of chronic low back pain. Staiger to gaster b sullivan md et al. The differentiation between specific and non specific low back pain is mandatory.
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