University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Occupational Medicine


Elizabeth Hart


Purpose: The purpose of this article is to review the management guidelines for non-traumatic low back pain, pharmacologic treatment options, non-pharmacological therapies, and the impact on military duty limitations.

Method: A PubMed literature search was conducted with search terms low back pain, pharmacologic, alternative, military, chiropractic, and therapy. Fifteen pertinent articles were retrieved and serve as the basis for this clinical review.

Results: Pharmacologic therapies that consistently demonstrate efficacy of pain relief are nonsteroidal anti-inflammatories. Evidence regarding acetaminophen, skeletal muscle relaxants and opioids is limited and controversial. Evidence supports that non-pharmacologic therapies, although controversial in their efficacy, can provide pain relief to military members with acute, non-traumatic low back pain.

Conclusion: Evidence supports the use of nonsteroidal anti-inflammatories as first-line treatment; but does not provide any indication or the muscle of skeletal muscle relaxants or opioids. Research outcomes also indicate that non-pharmacologic therapies such as chiropractic modalities, myofascial trigger point massage therapy and primary physical therapy can lead to a improvement in pain relief and disability. In addition, the use of non-pharmacologic therapy does not pre-dispose individuals to side effect profiles and will not propel the cycle of opioid abuse.

Keywords: Acute back pain, Military, Pharmacologic, Treatment


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