Last month, the American Pain Society added to its recommendations to health care providers regarding the diagnosis and treatment of low back pain .
In addition, the Society decided to discuss openly procedures that could be risky to sufferers of low back pain, including recommendations on surgery and other invasive therapies.
Unfortunately, there is not a significant body of good evidence to justify unquestioningly embracing these new recommendations. It is difficult to find well-done clinical studies which support the use of a number of the more invasive treatments used for chronic low back pain.
The initial set of guidelines for the management of chronic low back pain were published in "Annals of Internal Medicine" last October. However, these recommendations dealt more with the initial evaluation of a low back pain patient, and included thoughts on what type of x-rays to order in addition to more conservative treatments such as massage/manipulation and exerci...
Proper Care of the Body's Shock Absorbers Just like motor oil keeps your car running smoothly, there’s an important fluid that lubricates and nourishes your joints. This substance is called synovial (syn ō vi`al) fluid, and joints that contain it — like your shoulders and hips — are called synovial joints. As you move, sacks of this fluid cushion your knees and elbows against friction, and these sacks are known as bursae (bûr´s∂). When you hear people talk about tennis elbow — outer elbow pain often caused by repetitive motion — they actually have inflamed bursae, which doctors refer to as bursitis. Joint pain can interfere with your physical activity and daily life. The flip side, however, is that as your fitness level increases, joint pain may decrease. Here are some things you can do to encourage both of these desired results: * Warm up before any activity. Try this for your knees: Sit in a chair, and slowly raise your left foot un...
Alternative Names Backache; Low back pain; Lumbar pain; Pain - back; Acute back pain; Back pain - new; Back pain - short-term Prevention See: Taking care of your back at home References US Preventative Services Task Force. Primary Care Interventions to Prevent Low Back Pain: Brief Evidence Update . Rockville, MD: Agency for Healthcare Research and Quality; February 2004. Anema JR, Steenstra IA, Bongers PM, de Vet HC, Knol DL, Loisel P, van Mechelen W. Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both? A randomized controlled trial. Spine . 2007;32:291-298. Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med . 2007;147:478-491. Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet . 2009;373:463-472.
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