Guidelines for Back Pain Treatment and Evaluation
Briefly into this subject, if there are no red flags of serious pathology then no imaging or intervention is recommended unless the symptoms progress or go beyond 4-6 weeks. Most people with lower back pain will improve in 4 weeks and 90% will be symptom-free in 90 days.
Red flags in low back pain that prompt tests and imaging include:
- Suspected infection
- Cancer in the recent history
- Trauma
- Heavy lifting in an osteoporotic person
- Major and/or progressive sensory or motor deficit
- Loss of anal sphincter tone
- Bowel or bladder incontinence
- Urinary retention
- Saddle anesthesia
If no significant red flags and no contraindications, start treatment with Nonsteroidal anti-inflammatory drugs, acetaminophen, and/or muscle relaxants which are usually effective treatments for nonspecific acute low back pain. Avoid bed rest and encourage appropriate use of the back.
Interesting book for reading from Dr Bydon.
This post covers the points you need to know for your board exams as well as for teaching residents on the daily rounds. Medical professionals can't use the information here to treat their patients nor people can use the information her to treat themselves. If you are having any medical issues, contact your local emergency services. Please refer to your doctor for medical advice.