Dr. Tom Colletti, DHSc, PA-C, DFAAPA
Background: A large number of patients complain of a primary acute back pain episode every year and half of those complaints can resolve within four to six weeks with conservative therapies.
Methods: This review used specific criteria for literature search for review to develop a continuing medical education article.
Results: Patients who present for acute non-specific pain should have a thorough physical and history obtained. Identification of red flag signs or acute neurological changes should immediately indicate for imaging and referral. Non-specific pain should be evaluated and followed by appropriate conservative pharmacological and non-pharmacological therapies to improve pain until imaging can be deemed appropriate with possible referral to specialist services for possible invasive treatment such as surgery. Pharmacological treatment progression and numerous options for non-pharmacological therapies are reviewed. Therapies for physical activity show the greatest improvement of pain, and continuation of home exercises can help prevent recurrence. There is no evidence that bed rest, or activity restriction is beneficial to patients with acute pain but may prolong healing and recovery efforts of the patient.
Conclusion: Once red flag signs indicating serious injury have been ruled out in acute pain, the use of pharmacological and non-pharmacological therapies can improve half of all patients with a first time complaint of low back pain or new complaint after six months pain-free.
Fohringer C. Conservative therapies for acute non-specific low back pain. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2021; 3(3).
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