Updated clinical guidelines developed for patients age 18 and older with symptoms of low back pain or radiculopathy aim to increase conservative approaches, such as physical activity, as first-line treatment for this population.
The recommendations call for subjective pain rating; functional status; patient history, including notation of presence or absence of "red flags" and psychosocial indicators; assessment of prior treatment and response; employment status; and clinician's objective assessment. The guidelines also propose reducing unnecessary imaging unless "red flag" indicators exist, placing an emphasis on patient education and conservative home self-care, and returning "early" to work or activities. Additionally, they report that there is evidence that exercise therapy is effective for chronic back pain.
Evidence supporting the recommendations, the benefits/harms of implementing the guideline recommendations, and information about the guideline developers also is available.
Read the guidance from the Institute for Clinical Systems Improvement at the Agency for Healthcare Research and Quality's National Guideline Clearinghouse.