Tuesday, September 1, 2020

Acute Low Back Pain

Taming The SRU
Taming The SRU - August 31, 2020 - By Gillespie L
"Take away points
  • Nonspecific, acute low back pain can be thought of as a diagnosis of exclusion and other etiologies should be considered first.
  • The majority of people at some point in their lives experience low back pain, although it often improves significantly over the 1-3-month period that ensues. Unfortunately, there are high recurrence rates.
  • Treatment of acute low back pain in the ED is different than treatment of chronic low back pain.
  • Pharmacologic therapy can be combined with non-pharmacologic therapy for improved outcomes (ex. patient education).
  • NSAIDs show some mild benefit for analgesia and disability reduction. Acetaminophen has no recent, strong evidence supporting its use in acute low back pain.
  • Muscle relaxants have mixed results for treatment of acute low back pain, and have significant side effect profiles.
  • Lidocaine patches may provide significant benefit without burden of systemic adverse effects although there is not enough evidence to strengthen the argument for its routine use yet.
  • Treatment-focused patient education, especially regarding prognosis and expectations, is an essential component of nonpharmacological therapy for acute low back pain."