Management of Acute Back Pain in Military Primary Care: A Clinical Review

Authors

Erin Beaver, University of LynchburgFollow

Specialty

Primary Care

Advisor

Dr. Thomas Colletti

Abstract

Acute low back pain is the leading cause of musculoskeletal disability worldwide and a frequent presentation in military primary care. Effective management is vital in the armed forces, where prolonged pain reduces operational readiness, limits duty performance, and contributes to attrition from physically demanding roles. This review synthesizes evidence from eight high-quality systematic reviews, meta-analyses, and randomized controlled trials identified through PubMed to evaluate the most effective treatments for acute back pain in service members.

The strongest evidence supports pharmacologic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and non-benzodiazepine muscle relaxants. NSAIDs are particularly relevant in military practice because they are readily available in garrison clinics and austere environments through the Joint First Aid Kit (JFAK), enabling rapid pain relief even in deployed settings. Combination therapy has been shown to provide superior outcomes compared with single agents, with minimal adverse effects.

Non-pharmacologic interventions also demonstrate benefit. Structured physical therapy, exercise programs, and patient education improve pain and function while reducing the risk of chronicity. Battlefield acupuncture (BFA) provides a non-drug option that avoids cognitive impairment and has shown effectiveness in both clinical and operational environments, although training and certification requirements remain barriers to widespread adoption.

Despite the availability of multiple effective therapies, acute back pain remains a major challenge in military populations. Comparative trials tailored to military settings are needed to define optimal strategies that prevent back pain, reduce recurrence, accelerate recovery, and preserve operational readiness.

Recommended Citation

Beaver E. Management of Acute Back Pain in Military Primary Care: A Clinical Review. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2025; 7(3).