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Back Pain HELP
Based on 12,704 articles since 2006

These are the 12704 published articles about Back Pain that originated from Worldwide during 2006-2015.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline [German Society for Rheumatology S3 guidelines on axial spondyloarthritis including Bechterew's disease and early forms: 3 Clinical symptoms]. 2014

Kiltz, U / Rudwaleit, M / Sieper, J / Krause, D / Chenot, J-F / Stallmach, A / Jaresch, S / Oberschelp, U / Schneider, E / Swoboda, B / Böhm, H / Heiligenhaus, A / Pleyer, U / Böhncke, W-H / Stemmer, M / Braun, J / Anonymous5920790. ·Deutsche Gesellschaft für Rheumatologie (DGRh), -, -, Uta.Kiltz@elisabethgruppe.de. · ·Z Rheumatol · Pubmed #25181971.

ABSTRACT: -- No abstract --

2 Guideline Report of the National Institutes of Health task force on research standards for chronic low back pain. 2014

Deyo, Richard A / Dworkin, Samuel F / Amtmann, Dagmar / Andersson, Gunnar / Borenstein, David / Carragee, Eugene / Carrino, John / Chou, Roger / Cook, Karon / DeLitto, Anthony / Goertz, Christine / Khalsa, Partap / Loeser, John / Mackey, Sean / Panagis, James / Rainville, James / Tosteson, Tor / Turk, Dennis / Von Korff, Michael / Weiner, Debra K / Anonymous1310791. ·Professor, Department of Family Medicine, Oregon Health & Science University, Portland, OR; Professor, Department of Medicine, Oregon Health & Science University, Portland, OR; Professor, Department of Public Health & Community Medicine, Oregon Health & Science University, Portland, OR. Electronic address: deyor@ohsu.edu. · Professor, Department of Oral Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA. · Research Associate Professor, Department of Rehabilitation Medicine, University of Washington, Seattle, WA. · Professor, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL. · Clinical Professor, Department of Medicine, George Washington University Medical Center, Washington, DC. · Professor, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA. · Associate Professor, Department of Radiology, Johns Hopkins University, Baltimore, MD. · Professor, Department of Medicine, Oregon Health and Science University, Portland, OR; Professor, Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR. · Research Associate Professor, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL. · Professor, Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA. · Vice Chancellor of Research & Health Policy, Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA. · Deputy Director, National Institutes of Health, Division of Extramural Research, National Center for Complementary and Alternative Medicine, Bethesda, MD. · Professor Emeritus, Department of Neurological Surgery, University of Washington, Seattle, WA; Professor Emeritus, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA. · Professor, Department of Anesthesia and Pain Management, Stanford University, Stanford, CA. · Program Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Orthopaedics Research Program, Bethesda, MD. · Chief, Department of Physical Medicine and Rehabilitation, New England Baptist Hospital, Roxbury Crossing, MA. · Professor, Department of Community and Family Medicine and The Dartmouth Institute, Geisel School of Medicine at Dartmouth, Hanover, NH. · Professor Emeritus, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA. · Senior Investigator, Group Health Research Institute, Seattle, WA. · Professor, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Professor, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA; Professor, Department of Anesthesiology; University of Pittsburgh, Pittsburgh, PA. Geriatric Research, Educational and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA. · ·J Manipulative Physiol Ther · Pubmed #25127996.

ABSTRACT: OBJECTIVES: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed nonspecific and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. The purpose of this article is to disseminate the report of the National Institutes of Health (NIH) task force on research standards for cLBP. METHODS: The NIH Pain Consortium charged a research task force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel developed a 3-stage process, each with a 2-day meeting. RESULTS: The panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research subjects (drawing heavily on the Patient Reported Outcomes Measurement Information System methodology); reporting "responder analyses" in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved these recommendations, which investigators should incorporate into NIH grant proposals. CONCLUSIONS: The RTF believes that these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of cLBP. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes. We expect the RTF recommendations will become a dynamic document and undergo continual improvement.

3 Guideline Chronic nonspecific low back pain: rehabilitation. 2013

Anonymous5730765. ·Projeto Diretrizes da Associação Médica Brasileira, São Paulo, SP, Brasil. ·Rev Assoc Med Bras · Pubmed #24239032.

ABSTRACT: -- No abstract --

4 Guideline Referral strategy for early recognition of axial spondyloarthritis: consensus recommendations from the Hong Kong Society of Rheumatology. 2013

Mok, C C / Tam, L S / Leung, M H / Ying, K Y / To, C H / Lee, K L / Ho, L Y / Yip, M L / Tsui, H S / Chan, T H / Lee, K W / Li, E K M / Anonymous2340762. ·Department of Medicine, Tuen Mun Hospital. · ·Int J Rheum Dis · Pubmed #24164836.

ABSTRACT: Low back pain is one of commonest problems prompting a visit to the family physician. Up to 5% of patients with chronic low back pain in the primary care setting are diagnosed as having spondyloarthritis, which includes the prototype disease ankylosing spondylitis. Making a diagnosis of ankylosing spondylitis is often delayed for years, leading to significant pain, impairment of quality of life, disability and productivity loss. A recent breakthrough in the treatment of spondyloarthritis is the anti-tumor necrosis factor-alpha biologics, which lead to rapid relief of pain and inflammation, and improvement in all clinical parameters of the disease. Patients with early spondyloarthritis often respond better than those with late established disease. With proper recognition of inflammatory back pain, and the use of magnetic resonance imaging, spondyloarthritis can now be diagnosed much earlier before features are evident on plain radiographs. Referral to the rheumatologist based on onset of back pain (> 3 months) before the age of 45 years, and an inflammatory nature of the pain, or the presence of human leukocyte antigen-B27, or sacroiliitis by imaging, have been confirmed in multi-center international studies to be a pragmatic approach to enable early diagnosis of spondyloarthritis. This referral strategy has recently been adopted by the Hong Kong Society of Rheumatology for primary care physicians and non-rheumatology specialists.

5 Guideline Low back and radicular pain: a pathway for care developed by the British Pain Society. 2013

Lee, J / Gupta, S / Price, C / Baranowski, A P / Anonymous6570751. ·Pain Medicine, Cayman Islands Hospital, PO Box 915, Grand Cayman KY1-1103, Cayman Islands. john.lee@uclmail.net · ·Br J Anaesth · Pubmed #23794653.

ABSTRACT: These consensus guidelines aim to provide an overview of best practice for managing chronic spinal pain reflecting the heterogeneity of low back pain. Most guidelines have covered only one aspect of spinal care and thus have been divisive and potentially worsened the quality of care. Additionally, some of the evidence base is subjective and of poor quality. The British Pain Society low back pain pathway has reached across all disciplines and involved input from patients. It is recognized, however, that there is an urgent need for further good-quality clinical research in this area to underpin future guidelines. Considerable work is still needed to clarify the evidence; however, foundations have been laid with this pathway. Key features include: risk stratification; clarification of intensity of psychological interventions; a logical progression for the management of sciatica; and decision points for considering structural interventions such as spinal injections and surgery.

6 Guideline [Diagnosis and conservative treatment of low back pain: review and guidelines of the Croatian Vertebrologic Society]. 2012

Grazio, Simeon / Curković, Bozidar / Vlak, Tonko / Kes, Vanja Basić / Jelić, Miroslav / Buljan, Danijel / Gnjidić, Zoja / Nemcić, Tomislav / Grubisić, Frane / Borić, Igor / Kauzlarić, Neven / Mustapić, Matej / Demarin, Vida / Anonymous6530736. ·Klinika za reumatologiju, fizikalnu medicinu i rehabilitaciju, KBC Sestre milosrdnice, Zagreb, Hrvatska. simeon.grazio@zg.t-com.hr · ·Acta Med Croatica · Pubmed #23814971.

ABSTRACT: Low back pain (LBP) is a very common condition with high costs of patient care. Medical doctors of various specialties from Croatia have brought an up-to-date review and guidelines for diagnosis and conservative treatment of low back pain, which should result in the application of evidence-based care and eventually better outcomes. As LBP is a multifactorial disease, it is often not possible to identify which factors may be responsible for the onset of LBP and to what extent they aggravate the patient's symptoms. In the diagnostic algorithm, patient's history and clinical examination have the key role. Furthermore, most important is to classify patients into those with nonspecific back pain, LBP associated with radiculopathy (radicular syndrome) and LBP potentially associated with suspected or confirmed severe pathology. Not solely a physical problem, LBP should be considered through psychosocial factors too. In that case, early identification of patients who will develop chronic back pain will be helpful because it determines the choice of treatment. In order to make proper assessment of a patient with LBP (i.e. pain, function), we should use validated questionnaires. Useful approach to a patient with LBP is to apply the principles of content management. Generally, acute and chronic LBP cases are treated differently. Besides providing education, in patients with acute back pain, advice seems to be crucial (especially to remain active), along with the use of drugs (primarily in terms of pain control), while in some patients spinal manipulation (performed by educated professional) or/and short-term use of lumbosacral orthotic devices can also be considered. The main goal of treating patients with chronic LBP is renewal of function, even in case of persistent pain. For chronic LBP, along with education and medical treatment, therapeutic exercise, physical therapy and massage are recommended, while in patients with a high level of disability intensive multidisciplinary biopsychosocial approach has proved to be effective.

7 Guideline Clinical policy: critical issues in the prescribing of opioids for adult patients in the emergency department. 2012

Cantrill, Stephen V / Brown, Michael D / Carlisle, Russell J / Delaney, Kathleen A / Hays, Daniel P / Nelson, Lewis S / O'Connor, Robert E / Papa, Annmarie / Sporer, Karl A / Todd, Knox H / Whitson, Rhonda R / Anonymous1760728. · ·Ann Emerg Med · Pubmed #23010181.

ABSTRACT: -- No abstract --

8 Guideline Low back pain. 2012

Delitto, Anthony / George, Steven Z / Van Dillen, Linda R / Whitman, Julie M / Sowa, Gwendolyn / Shekelle, Paul / Denninger, Thomas R / Godges, Joseph J / Anonymous920714. ·School of Health & Rehabilitation Sciences, University of Pittsburgh, Pennsylvania, USA. delitto@pitt.edu · ·J Orthop Sports Phys Ther · Pubmed #22466247.

ABSTRACT: The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF). The purpose of these low back pain clinical practice guidelines, in particular, is to describe the peer-reviewed literature and make recommendations related to (1) treatment matched to low back pain subgroup responder categories, (2) treatments that have evidence to prevent recurrence of low back pain, and (3) treatments that have evidence to influence the progression from acute to chronic low back pain and disability.

9 Guideline Practice guidelines for the management of low back pain. Consensus Group of Practice Parameters to Manage Low Back Pain. 2011

Guevara-López, Uría / Covarrubias-Gómez, Alfredo / Elías-Dib, Jorge / Reyes-Sánchez, Alejandro / Rodríguez-Reyna, Tatiana Sofía / Anonymous3040705. ·Dirección de Educación e Investigación en Salud, Unidad Médica de Alta Especialidad Dr. Victorio de la Fuente Narváez, Instituto Mexicano del Seguro Social, México, DF, Mexico. uriahguevara91@yahoo.com.mx · ·Cir Cir · Pubmed #22381000.

ABSTRACT: It has been documented that pain in its diverse modalities is the most common cause of medical attention. In Mexico, an increase in its frequency has promoted its consideration in several health programs. On the other hand, inadequate pain management will cause severe physical, psychoaffective, and socioeconomic repercussions for patients, families, and public health services. Despite this panorama, there has not been an agreement to establish better diagnostic and therapeutic methods for the management of chronic pain. A consensus group was reunited and was integrated by medical experts from private and public institutions and from various states of the Mexican Republic. To assure the development of these practice guidelines, these experts had experience in the assessment and treatment of conditions causing pain. With the guidelines used by other consensus groups, meetings were held to analyze and discuss published literary evidence for the management of low back pain. The recommendations were classified according to their methodological strength. As a result of this meeting, consensus recommendations were based on evidence and operational conclusions of such proactive educational plans, institutional policies and diagnostic recommendations for pharmacological and nonpharmacological treatment in order for Mexican physicians to provide a better therapeutic approach to low back pain.

10 Guideline [Epidural spinal cord stimulation for therapy of chronic pain. Summary of the S3 guidelines]. 2011

Tronnier, V / Baron, R / Birklein, F / Eckert, S / Harke, H / Horstkotte, D / Hügler, P / Hüppe, M / Kniesel, B / Maier, C / Schütze, G / Thoma, R / Treede, R D / Vadokas, V / Anonymous4630697. ·Neurochirurgische Klinik, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Deutschland. volker.tronnier@uk-sh.de · ·Schmerz · Pubmed #21938604.

ABSTRACT: Epidural spinal cord stimulation (SCS) is a reversible but invasive procedure which should be used for neuropathic pain, e.g. complex regional pain syndrome I (CRPS) and for mostly chronic radiculopathy in connection with failed back surgery syndrome following unsuccessful conservative therapy. Epidural SCS can also successfully be used after exclusion of curative procedures and conservative therapy attempts for vascular-linked pain, such as in peripheral arterial occlusive disease stages II and III according to Fontaine and refractory angina pectoris. Clinical practice has shown which clinical symptoms cannot be successfully treated by epidural SCS, e.g. pain in complete paraplegia syndrome or atrophy/injury of the sensory pathways of the spinal cord or cancer pain. A decisive factor is a critical patient selection as well as the diagnosis. Epidural SCS should always be used within an interdisciplinary multimodal therapy concept. Implementation should only be carried out in experienced therapy centers which are in a position to deal with potential complications.

11 Guideline Evidence-based risk assessment and recommendations for physical activity: arthritis, osteoporosis, and low back pain. 2011

Chilibeck, Philip D / Vatanparast, Hassanali / Cornish, Stephen M / Abeysekara, Saman / Charlesworth, Sarah. ·College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, Canada. phil.chilibeck@usask.ca · ·Appl Physiol Nutr Metab · Pubmed #21800948.

ABSTRACT: We systematically reviewed the safety of physical activity (PA) for people with arthritis, osteoporosis, and low back pain. We searched PubMed, MEDLINE, Sport Discus, and the Cochrane Central Register of Controlled Trials (1966 through March 2008) for relevant articles on PA and adverse events. A total of 111 articles met our inclusion criteria. The incidence for adverse events during PA was 3.4%-11% (0.06%-2.4% serious adverse events) and included increased joint pain, fracture, and back pain for those with arthritis, osteoporosis, and low back pain, respectively. Recommendations were based on the Appraisal of Guidelines for Research and Evaluation, which applies Levels of Evidence based on type of study ranging from high-quality randomized controlled trials (Level 1) to anecdotal evidence (Level 4) and Grades from A (strong) to C (weak). Our main recommendations are that (i) arthritic patients with highly progressed forms of disease should avoid heavy load-bearing activities, but should participate in non-weight-bearing activities (Level 2, Grade A); and (ii) patients with osteoporosis should avoid trunk flexion (Level 2, Grade A) and powerful twisting of the trunk (Level 3, Grade C); (iii) patients with acute low back pain can safely do preference-based PA (i.e., PA that does not induce pain), including low back extension and flexion (Level 2, Grade B); (iv) arthritic patients with stable disease without progressive joint damage and patients with stable osteoporosis or low back pain can safely perform a variety of progressive aerobic or resistance-training PAs (Level 2, Grades A and B). Overall, the adverse event incidence from reviewed studies was low. PA can safely be done by most individuals with musculoskeletal conditions.

12 Guideline American Osteopathic Association guidelines for osteopathic manipulative treatment (OMT) for patients with low back pain. 2010

Anonymous5280674 / Anonymous5290674. · ·J Am Osteopath Assoc · Pubmed #21135197.

ABSTRACT: BACKGROUND: Osteopathic manipulative treatment (OMT) is a distinctive modality commonly used by osteopathic physicians to complement conventional treatment of musculoskeletal disorders, including those that cause low back pain. Osteopathic manipulative treatment is defined in the Glossary of Osteopathic Terminology as: "The therapeutic application of manually guided forces by an osteopathic physician (US Usage) to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction. OMT employs a variety of techniques." Somatic dysfunction is defined as: "Impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial and myofascial structures, and their related vascular, lymphatic, and neural elements. Somatic dysfunction is treatable using osteopathic manipulative treatment." Previous published guidelines have been based on literature reviews and meta-analyses of spinal manipulation for low back pain. They have not specifically addressed OMT and generally have focused on spinal manipulation as an alternative to conventional treatment. The purpose of this study was to assess the efficacy of OMT for somatic dysfunction associated with low back pain by osteopathic physicians and osteopathic practitioners trained in osteopathic palpatory diagnosis and manipulative treatment. METHODS: Computerized bibliographic searches of MEDLINE, OLDMEDLINE, EMBASE, AMED, MANTIS, OSTMED (OSTMED.DR), and the Cochrane Central Register of Controlled Trials were supplemented with additional database and manual searches of the literature. Six trials, involving eight OMT vs control treatment comparisons, were included because they were randomized controlled trials of OMT that involved blinded assessment of low back pain in ambulatory settings. Data on trial methodology, OMT and control treatments, and low back pain outcomes were abstracted by two independent reviewers. Effect sizes were computed using Cohen d statistic, and meta-analysis results were weighted by the inverse variance of individual comparisons. In addition to the overall meta-analysis, subgroup meta-analyses were performed according to control treatment, country where the trial was conducted, and duration of follow-up. Sensitivity analyses were performed for both the overall and subgroup meta-analyses. RESULTS: Osteopathic manipulative treatment significantly reduced low back pain (effect size, -0.30; 95% confidence interval, -0.47 to -0.13; P=.001). Subgroup analyses demonstrated significant pain reductions in trials of OMT vs active treatment or placebo control and OMT vs no treatment control. There were significant pain reductions with OMT regardless of whether trials were performed in the United Kingdom or the United States. Significant pain reductions were also observed during short-, inter mediate-, and long-term follow-up. CONCLUSIONS: Osteopathic manipulative treatment significantly reduces low back pain. The level of pain reduction is clinically important, greater than expected from placebo effects alone, and may persist through the first year of treatment. Additional research is warranted to elucidate mechanistically how OMT exerts its effects, to determine if OMT benefits extend beyond the first year of treatment, and to assess the cost-effectiveness of OMT as a complementary treatment for low back pain.

13 Guideline Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. 2009

Manchikanti, Laxmaiah / Boswell, Mark V / Singh, Vijay / Benyamin, Ramsin M / Fellows, Bert / Abdi, Salahadin / Buenaventura, Ricardo M / Conn, Ann / Datta, Sukdeb / Derby, Richard / Falco, Frank J E / Erhart, Stephanie / Diwan, Sudhir / Hayek, Salim M / Helm, Standiford / Parr, Allan T / Schultz, David M / Smith, Howard S / Wolfer, Lee R / Hirsch, Joshua A / Anonymous2740639. ·Pain Management Center of Paducah, Paducah, KY, USA. drlm@thepainmd.com · ·Pain Physician · Pubmed #19644537.

ABSTRACT: BACKGROUND: Comprehensive, evidence-based guidelines for interventional techniques in the management of chronic spinal pain are described here to provide recommendations for clinicians. OBJECTIVE: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain. DESIGN: Systematic assessment of the literature. METHODS: Strength of evidence was assessed by the U.S. Preventive Services Task Force (USPSTF) criteria utilizing 5 levels of evidence ranging from Level I to III with 3 subcategories in Level II. OUTCOMES: Short-term pain relief was defined as relief lasting at least 6 months and long-term relief was defined as longer than 6 months, except for intradiscal therapies, mechanical disc decompression, spinal cord stimulation and intrathecal infusion systems, wherein up to one year relief was considered as short-term. RESULTS: The indicated evidence for accuracy of diagnostic facet joint nerve blocks is Level I or II-1 in the diagnosis of lumbar, thoracic, and cervical facet joint pain. The evidence for lumbar and cervical provocation discography and sacroiliac joint injections is Level II-2, whereas it is Level II-3 for thoracic provocation discography. The indicated evidence for therapeutic interventions is Level I for caudal epidural steroid injections in managing disc herniation or radiculitis, and discogenic pain without disc herniation or radiculitis. The evidence is Level I or II-1 for percutaneous adhesiolysis in management of pain secondary to post-lumbar surgery syndrome. The evidence is Level II-1 or II-2 for therapeutic cervical, thoracic, and lumbar facet joint nerve blocks; for caudal epidural injections in managing pain of post-lumbar surgery syndrome, and lumbar spinal stenosis, for cervical interlaminar epidural injections in managing cervical pain (Level II-1); for lumbar transforaminal epidural injections; and spinal cord stimulation for post-lumbar surgery syndrome. The indicated evidence for intradiscal electrothermal therapy (IDET), mechanical disc decompression with automated percutaneous lumbar discectomy (APLD), and percutaneous lumbar laser discectomy (PLDD) is Level II-2. LIMITATIONS: The limitations of these guidelines include a continued paucity of the literature, lack of updates, and conflicts in preparation of systematic reviews and guidelines by various organizations. CONCLUSION: The indicated evidence for diagnostic and therapeutic interventions is variable from Level I to III. These guidelines include the evaluation of evidence for diagnostic and therapeutic procedures in managing chronic spinal pain and recommendations for managing spinal pain. However, these guidelines do not constitute inflexible treatment recommendations. Further, these guidelines also do not represent "standard of care."

14 Guideline Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. 2009

Chou, Roger / Loeser, John D / Owens, Douglas K / Rosenquist, Richard W / Atlas, Steven J / Baisden, Jamie / Carragee, Eugene J / Grabois, Martin / Murphy, Donald R / Resnick, Daniel K / Stanos, Steven P / Shaffer, William O / Wall, Eric M / Anonymous1160633. ·Department of Medicine, Oregon Evidence-based Practice Center, Oregon Health and Science University, Portland, OR, USA. chour@ohsu.edu · ·Spine (Phila Pa 1976) · Pubmed #19363457.

ABSTRACT: 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 and disabling low back pain remains a clinical challenge. A number of interventional diagnostic tests and therapies and surgery are available and their use is increasing, but in some cases their utility remains uncertain or controversial. Interdisciplinary rehabilitation has also been proposed as a potentially effective noninvasive intervention for persistent and disabling low back pain. METHODS: A multidisciplinary panel was convened by the American Pain Society. Its recommendations were based on a systematic review that focused on evidence from randomized controlled trials. Recommendations were graded using methods adapted from the US Preventive Services Task Force and the Grading of Recommendations, Assessment, Development, and Evaluation Working Group. RESULTS: Investigators reviewed 3348 abstracts. A total of 161 randomized trials were deemed relevant to the recommendations in this guideline. The panel developed a total of 8 recommendations. CONCLUSION: Recommendations on use of interventional diagnostic tests and therapies, surgery, and interdisciplinary rehabilitation are presented. Due to important trade-offs between potential benefits, harms, costs, and burdens of alternative therapies, shared decision-making is an important component of a number of the recommendations.

15 Guideline Diagnosis and management of patients at risk of or with metastatic spinal cord compression: summary of NICE guidance. 2008

White, B D / Stirling, A J / Paterson, E / Asquith-Coe, K / Melder, A / Anonymous3450621. ·Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH. barrie.white@nuh.nhs.uk · ·BMJ · Pubmed #19039017.

ABSTRACT: -- No abstract --

16 Guideline A review and proposal for a core set of factors for prospective cohorts in low back pain: a consensus statement. 2008

Pincus, Tamar / Santos, Rita / Breen, Alan / Burton, A Kim / Underwood, Martin / Anonymous370602. ·Royal Holloway, University of London, London, UK. t.pincus@rhul.ac.uk · ·Arthritis Rheum · Pubmed #18163411.

ABSTRACT: -- No abstract --

17 Guideline Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. 2007

Chou, Roger / Qaseem, Amir / Snow, Vincenza / Casey, Donald / Cross, J Thomas / Shekelle, Paul / Owens, Douglas K / Anonymous4870593 / Anonymous4880593 / Anonymous4890593. ·Oregon Health & Science University, Portland, Oregon, USA. · ·Ann Intern Med · Pubmed #17909209.

ABSTRACT: RECOMMENDATION 1: Clinicians should conduct a focused history and physical examination to help place patients with low back pain into 1 of 3 broad categories: nonspecific low back pain, back pain potentially associated with radiculopathy or spinal stenosis, or back pain potentially associated with another specific spinal cause. The history should include assessment of psychosocial risk factors, which predict risk for chronic disabling back pain (strong recommendation, moderate-quality evidence). RECOMMENDATION 2: Clinicians should not routinely obtain imaging or other diagnostic tests in patients with nonspecific low back pain (strong recommendation, moderate-quality evidence). RECOMMENDATION 3: Clinicians should perform diagnostic imaging and testing for patients with low back pain when severe or progressive neurologic deficits are present or when serious underlying conditions are suspected on the basis of history and physical examination (strong recommendation, moderate-quality evidence). RECOMMENDATION 4: Clinicians should evaluate patients with persistent low back pain and signs or symptoms of radiculopathy or spinal stenosis with magnetic resonance imaging (preferred) or computed tomography only if they are potential candidates for surgery or epidural steroid injection (for suspected radiculopathy) (strong recommendation, moderate-quality evidence). RECOMMENDATION 5: Clinicians should provide patients with evidence-based information on low back pain with regard to their expected course, advise patients to remain active, and provide information about effective self-care options (strong recommendation, moderate-quality evidence). RECOMMENDATION 6: For patients with low back pain, clinicians should consider the use of medications with proven benefits in conjunction with back care information and self-care. Clinicians should assess severity of baseline pain and functional deficits, potential benefits, risks, and relative lack of long-term efficacy and safety data before initiating therapy (strong recommendation, moderate-quality evidence). For most patients, first-line medication options are acetaminophen or nonsteroidal anti-inflammatory drugs. RECOMMENDATION 7: For patients who do not improve with self-care options, clinicians should consider the addition of nonpharmacologic therapy with proven benefits-for acute low back pain, spinal manipulation; for chronic or subacute low back pain, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation (weak recommendation, moderate-quality evidence).

18 Guideline [Evidence and consensus based Austrian guidelines for management of acute and chronic nonspecific backache]. 2007

Anonymous40583. · ·Wien Klin Wochenschr · Pubmed #17427024.

ABSTRACT: -- No abstract --

19 Guideline Coccygodynia. 2007

Mlitz, Horst / Jost, W / Anonymous6300580 / Anonymous6310580. ·Department of Dermatology, University of Aachen, Aachen, Germany. · ·J Dtsch Dermatol Ges · Pubmed #17338803.

ABSTRACT: -- No abstract --

20 Guideline Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. 2007

Boswell, Mark V / Trescot, Andrea M / Datta, Sukdeb / Schultz, David M / Hansen, Hans C / Abdi, Salahadin / Sehgal, Nalini / Shah, Rinoo V / Singh, Vijay / Benyamin, Ramsin M / Patel, Vikram B / Buenaventura, Ricardo M / Colson, James D / Cordner, Harold J / Epter, Richard S / Jasper, Joseph F / Dunbar, Elmer E / Atluri, Sairam L / Bowman, Richard C / Deer, Timothy R / Swicegood, John R / Staats, Peter S / Smith, Howard S / Burton, Allen W / Kloth, David S / Giordano, James / Manchikanti, Laxmaiah / Anonymous4530578. ·American Society of Interventional Pain Physicians, Paducah, KY 42001, USA. mark.boswell@ttuhsc.edu · ·Pain Physician · Pubmed #17256025.

ABSTRACT: BACKGROUND: The evidence-based practice guidelines for the management of chronic spinal pain with interventional techniques were developed to provide recommendations to clinicians in the United States. OBJECTIVE: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain, utilizing all types of evidence and to apply an evidence-based approach, with broad representation by specialists from academic and clinical practices. DESIGN: Study design consisted of formulation of essentials of guidelines and a series of potential evidence linkages representing conclusions and statements about relationships between clinical interventions and outcomes. METHODS: The elements of the guideline preparation process included literature searches, literature synthesis, systematic review, consensus evaluation, open forum presentation, and blinded peer review. Methodologic quality evaluation criteria utilized included the Agency for Healthcare Research and Quality (AHRQ) criteria, Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria, and Cochrane review criteria. The designation of levels of evidence was from Level I (conclusive), Level II (strong), Level III (moderate), Level IV (limited), to Level V (indeterminate). RESULTS: Among the diagnostic interventions, the accuracy of facet joint nerve blocks is strong in the diagnosis of lumbar and cervical facet joint pain, whereas, it is moderate in the diagnosis of thoracic facet joint pain. The evidence is strong for lumbar discography, whereas, the evidence is limited for cervical and thoracic discography. The evidence for transforaminal epidural injections or selective nerve root blocks in the preoperative evaluation of patients with negative or inconclusive imaging studies is moderate. The evidence for diagnostic sacroiliac joint injections is moderate. The evidence for therapeutic lumbar intraarticular facet injections is moderate for short-term and long-term improvement, whereas, it is limited for cervical facet joint injections. The evidence for lumbar and cervical medial branch blocks is moderate. The evidence for medial branch neurotomy is moderate. The evidence for caudal epidural steroid injections is strong for short-term relief and moderate for long-term relief in managing chronic low back and radicular pain, and limited in managing pain of postlumbar laminectomy syndrome. The evidence for interlaminar epidural steroid injections is strong for short-term relief and limited for long-term relief in managing lumbar radiculopathy, whereas, for cervical radiculopathy the evidence is moderate. The evidence for transforaminal epidural steroid injections is strong for short-term and moderate for long-term improvement in managing lumbar nerve root pain, whereas, it is moderate for cervical nerve root pain and limited in managing pain secondary to lumbar post laminectomy syndrome and spinal stenosis. The evidence for percutaneous epidural adhesiolysis is strong. For spinal endoscopic adhesiolysis, the evidence is strong for short-term relief and moderate for long-term relief. For sacroiliac intraarticular injections, the evidence is moderate for short-term relief and limited for long-term relief. The evidence for radiofrequency neurotomy for sacroiliac joint pain is limited. The evidence for intradiscal electrothermal therapy is moderate in managing chronic discogenic low back pain, whereas for annuloplasty the evidence is limited. Among the various techniques utilized for percutaneous disc decompression, the evidence is moderate for short-term and limited for long-term relief for automated percutaneous lumbar discectomy, and percutaneous laser discectomy, whereas it is limited for nucleoplasty and for DeKompressor technology. For vertebral augmentation procedures, the evidence is moderate for both vertebroplasty and kyphoplasty. The evidence for spinal cord stimulation in failed back surgery syndrome and complex regional pain syndrome is strong for short-term relief and moderate for long-term relief. The evidence for implantable intrathecal infusion systems is strong for short-term relief and moderate for long-term relief. CONCLUSION: These guidelines include the evaluation of evidence for diagnostic and therapeutic procedures in managing chronic spinal pain and recommendations for managing spinal pain. However, these guidelines do not constitute inflexible treatment recommendations. These guidelines also do not represent a "standard of care."

21 Guideline Diagnostic therapeutic flow-charts for low back pain patients: the Italian clinical guidelines. 2006

Negrini, S / Giovannoni, S / Minozzi, S / Barneschi, G / Bonaiuti, D / Bussotti, A / D'Arienzo, M / Di Lorenzo, N / Mannoni, A / Mattioli, S / Modena, V / Padua, L / Serafini, F / Violante, F S. ·ISICO (Italian Scientific Spine Institute), Milan, Don Carlo Gnocchi Foundation, ONLUS, IRCCS, Milan, Italy. stefano.negrini@isico.it · ·Eura Medicophys · Pubmed #16767064.

ABSTRACT: -- No abstract --

22 Guideline Chapter 4. European guidelines for the management of chronic nonspecific low back pain. 2006

Airaksinen, O / Brox, J I / Cedraschi, C / Hildebrandt, J / Klaber-Moffett, J / Kovacs, F / Mannion, A F / Reis, S / Staal, J B / Ursin, H / Zanoli, G / Anonymous6370558. · ·Eur Spine J · Pubmed #16550448.

ABSTRACT: -- No abstract --

23 Guideline Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. 2006

van Tulder, Maurits / Becker, Annette / Bekkering, Trudy / Breen, Alan / del Real, Maria Teresa Gil / Hutchinson, Allen / Koes, Bart / Laerum, Even / Malmivaara, Antti / Anonymous6360558. · ·Eur Spine J · Pubmed #16550447.

ABSTRACT: -- No abstract --

24 Guideline Chapter 2. European guidelines for prevention in low back pain : November 2004. 2006

Burton, A K / Balagué, F / Cardon, G / Eriksen, H R / Henrotin, Y / Lahad, A / Leclerc, A / Müller, G / van der Beek, A J / Anonymous6350558. · ·Eur Spine J · Pubmed #16550446.

ABSTRACT: -- No abstract --

25 Editorial Spinal disorders, quality-based healthcare and spinal registers. 2015

Fairbank, Jeremy. ·a Professor of Spine Surgery, University of Oxford , UK. ·Acta Orthop · Pubmed #26169065.

ABSTRACT: -- No abstract --