Clinical Practice Guidelines for the diagnosis and treatment of low back pain have been published in the Annals of Internal Medicine by the American College of Physicians and the American Pain Society.

Here are recommendations #6 and #7.

Recommendation 6: Consider medications with proven benefits.

• For most patients, first-line medication options are acetaminophen or nonsteroidal anti-inflammatory drugs.

Recommendation 7: For patients who do not improve with self-care options…

• Consider adding nonpharmacologic therapy with proven benefits.
• For acute low back pain: spinal manipulation.
• For chronic or subacute low back pain: intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation (weak recommendation, moderate-quality evidence).

10/3/07 10:26 JR