CLINICAL PRACTICE GUIDELINES FROM THE AMERICAN COLLEGE OF PHYSICIANS: NONINVASIVE TREATMENTS FOR ACUTE, SUBACUTE AND CHRONIC LOW BACK PAIN
College of physicians recently published guidelines for the treatment of low
back pain (Annals of Internal Medicine, 2017). Three basic recommendations were
made and are reprinted below:
“Given that most patients with acute or
subacute low back pain improve over time regardless of treatment, clinicians
and patients should select nonpharmacologic treatment with superficial heat
(moderate-quality evidence), massage, acupuncture, or spinal manipulation
(low-quality evidence). If pharmacologic treatment is desired, clinicians and
patients should select nonsteroidal anti-inflammatory drugs or skeletal muscle
relaxants (moderate-quality evidence). (Grade: strong recommendation).”
“For patients with chronic low back
pain, clinicians and patients should initially select nonpharmacologic
treatment with exercise, multidisciplinary rehabilitation, acupuncture,
mindfulness-based stress reduction (moderate-quality evidence), tai chi, yoga,
motor control exercise, progressive
relaxation, electromyography feedback, low-level laser therapy, operant
therapy, cognitive behavioral therapy, or spinal manipulation (low-quality
evidence). (Grade: strong recommendation)”.
“In patients with chronic low back pain
who have had an inadequate response to nonpharmacologic therapy, clinicians and
patients should consider pharmacologic treatment with nonsteroidal
anti-inflammatory drugs as first-line therapy, or tramadol or duloxetine as second-line
therapy. Clinicians should only consider opioids as an option in patients who
have failed the aformentioned treatments and only if the potential benefits
outweigh the risks for individual patients and after discussion of known risks
and realistic benefits with patients. (Grade: week recommendation,
Note: The American Academy of Spine Physicians
(AAS P) recommends that patients with radiculopathy (pain radiating down the
leg, with or without sensory and/or motor abnormalities) the treatment plan
will be developed by their spine physician informed by the patient history and
Inform a Colleague
Expand and Educate Your Spinecare Network
Welcome to the Inform a Colleague area of the Academy Website. The American Academy of Spine Physicians (AASP) strives to implement new and more efficient methods for members to communicate with other healthcare professionals. One of the most effective tools is the online "Inform a Colleague" function. This function can be used to expand and educate your spinecare referral network. It also represents a resource to conveniently inform others about trends in spinecare and about offers of organizations such as the American Academy of Spine Physicians (AASP), the International Spine Association (ISA). The link library also contains an application for membership with the AASP.
The online "Inform a Colleague" feature provides an invaluable time-saving service for keeping spinecare professionalsup-to-date, expanding the spinecare network, stimulating interdisciplinary referrals and for inviting colleagues to join the AASP. The library of links is always being updated with useful information and resources. The linked messages can be used to
***Edit and/or add text where appropriate** (Inform one or more colleagues)
Join / Renew
This level of membership is for physicians (MD, DC, DO) whose practice/interest includes patients with spinal disorders. ($295)
This level of membership is for allied healthcare professionals involved in spinecare and/or spine research. This includes physical therapists, massage therapists, exercise physiologists, nurse practitioners, nurses, physician's assistants, diagnostic technicians, surgical technicians, exercise instructors, personal trainers and individuals who hold a PhD and work in the field of spinecare. ($150)
This level of membership is for residents, fellows and students who have an interest in spinecare. ($35)
Membership will automatically renew each calendar year starting from the date of membership renewal or membership acceptance unless the AASP is specifically notified in writing by the member at least 30 days prior to their renewal date. Please address all correspondence to the AASP Office of Member Services.
Review the accuracy of your contact information and practice profile information including your email address. To update your profile online go to www.spinephysicians.org and login using your unique member ID and PIN as noted below.
Please notify the AASP if you no longer meet membership criteria.
This includes maintaining an active license to practice.
American Academy of Spine Physicians