Rockville, MD: Agency for Healthcare Research and Quality; February 2016.This summary was prepared by the John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine, Houston, TX. PMID: 19595577.Although clinical practice guidelines recommend acetaminophen as treatment for acute and chronic low back pain, The information in this summary comes from Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt E. Noninvasive Treatments for Low Back Pain. For additional details on the methodology used to assess strength of evidence, please refer to: Owens DK, Lohr KN, Atkins D, et al. Rockville, MD: Agency for Healthcare Research and Quality; February 2016.Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt ED. Case 1: Back Pain A 42-year-old male reports pain in his lower back for the past month.
Few trials evaluated the effectiveness of treatments for radicular low back pain, but the available evidence found that benzodiazepines, corticosteroids, traction, and spinal manipulation were not effective or were associated with small effects (SOE: low). Visit the PBRN Profiles page to learn more about the breadth of PBRN research and activities. Focus of This Summary. Pain Management Injection Therapies for Low Back Pain. This review examines the evidence on the comparative benefits and harms of noninvasive treatments for low back pain.A prior systematic review (searches through October 2008), electronic databases (Ovid MEDLINEUsing predefined criteria, we selected systematic reviews of randomized trials of pharmacological treatments (acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs], opioids, skeletal muscle relaxants, benzodiazepines, antidepressants, antiseizure medications, and systemic corticosteroids) and nonpharmacological treatments (psychological therapies, multidisciplinary rehabilitation, spinal manipulation, acupuncture, massage, exercise and related therapies, and various physical modalities) for nonradicular or radicular low back pain that addressed effectiveness or harms versus placebo, no treatment, usual care, a sham therapy, an inactive therapy, or another active therapy. HHSA 290-2012-00014-I.) Studies have shown that improvements in pain (mean reduction to 58% of initial pain scores) occurred in 1 month.Multiple treatment options for acute and chronic low back pain are available. Technology Assessment Report ESIB0813. More research is needed to understand optimal selection of treatments, effective combinations and sequencing of treatments, effectiveness of treatments for radicular low back pain, and effectiveness on outcomes other than pain and function.Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt E. Noninvasive Treatments for Low Back Pain. Indicator Changes. Other domains were considered, as appropriate: dose-response association, plausible confounding, and strength of association (i.e., magnitude of effect).
Radiculopathy (characterized by pain, numbness, tingling, or weakness in the arms or legs) may be caused by nerve root impingement that often results from a herniated intervertebral disc or may be caused by spinal stenosis. 2010 May;63(5):513-23. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No.
Between 1992 and 1996, the Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality) sponsored development of a series of 19 clinical practice guidelines. 169, prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 169. Findings may be used for research purposes, but should not be considered current. Excluded from the review were studies conducted among patients with low back pain related to cancer, infection, inflammatory arthropathy, high-velocity trauma, or … Bougatsos C, Jarvik J. Low back pain is common and injections with corticosteroids are a frequently used treatment option. No abnormalities noted. We also included randomized trials that were not in systematic reviews. It was written by Geetha Achanta, Ph.D., David Gilchrist, M.D., Frank Domino, M.D., and Michael Fordis, M.D.Archived: This report is greater than 3 years old. Most trials enrolled patients with pain symptoms of at least moderate intensity (e.g., >5 on a 0- to 10-point numeric rating scale for pain). May 23, 2019 - AHRQ announces the retirement of 21 indicators in v2019: PQI, IQI, PSI and PDI Indicators. Journal Publications. This review examines the evidence on the comparative benefits and harms of noninvasive treatments for low back pain. 16-EHC004-EF. AHRQ Publication No. ... Agency for Healthcare Research and Quality; July 2015.
For nonpharmacological therapies, assessment of harms was suboptimal, but serious harms appeared to be rare (SOE: low).A number of pharmacological and nonpharmacological noninvasive treatments for low back pain are associated with small to moderate, primarily short-term effects on pain versus placebo, sham, wait list, or no treatment. 290-2012-00014-I for the Agency for Healthcare Research and Quality…
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