ITEMS IN AFP WITH KEYWORD:
Nonsteroidal anti-inflammatory drugs are a better choice for the treatment of low back pain. Despite benzodiazepine and nonbenzodiazepine muscle relaxants being used for almost 50 years to treat low back pain, the supporting evidence is of low certainty. None of the treatments will produce a clinically important difference over placebo.
Epidural corticosteroid injections provide a small and probably clinically insignificant reduction in leg and back pain in the immediate term (less than two weeks), and a small to moderate reduction in disability in the short and intermediate terms.
What interventions are effective in managing patients with chronic low back pain?
Apr 1, 2021 Issue
Epidural Corticosteroid Injections for Lumbosacral Radicular Pain [Cochrane for Clinicians]
Epidural corticosteroid injections for the treatment of lumbosacral radicular pain may offer modest short-term (two weeks to three months) benefit compared with placebo injection for radicular leg pain.
Over three weeks, patients with long-term low back pain who knowingly took placebo twice a day reported less pain and disability than those continuing with treatment as usual.
Typical causes of back pain in younger patients include muscle strain or spasm, spinal deformities, spondylolysis, bulging or herniated intervertebral disks, apophysitis of the iliac crest, and functional pain syndromes. Treatment is generally conservative.
Adding a muscle relaxant to treatment with ibuprofen does not improve functional outcomes or pain, or lessen the number of people reporting moderate to severe back pain one week after starting treatment.
Prescribing physical activity, including core strengthening, physical therapy, or yoga, is an important therapeutic intervention in patients with nonspecific low back pain. Early return to work should be encouraged when appropriate. Stress management counseling may also be beneficial.
Sep 1, 2019 Issue
Gabapentin for Treatment of Radicular Low Back Pain [FPIN's Clinical Inquiries]
Gabapentin is not effective for the treatment of radicular low back pain and is associated with adverse effects.
Aug 15, 2019 Issue
Asthma, Back and Neck Pain, Pain During Labor, TIA, CBT for Anxiety [AFP Clinical Answers]
Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.