Fast Five Quiz: How Much Do You Know About Mechanical Low Back Pain?

James W. Pritchett, MD

Disclosures

December 15, 2017

Evidence-based clinical practice guidelines from the APS for patients with chronic low back pain describe the use of interventional diagnostic tests and therapies, surgeries, and interdisciplinary rehabilitation. Practice guidelines for nonradicular pain include the following:

  • Interdisciplinary rehabilitation emphasizing cognitive-behavioral approaches should be considered for patients who do not respond to usual interventions.

  • Provocative discography (injecting material into a disc nucleus in an attempt to reproduce the patient's typical pain) is not recommended.

  • Facet joint corticosteroid injection, prolotherapy (repeated injections of irritant material to stimulate an inflammatory response), and intradiscal corticosteroid injection are not recommended.

  • Persistent disabling symptoms and degenerative spinal changes should prompt discussion and shared decision-making regarding surgery or interdisciplinary rehabilitation (evidence is insufficient to weigh the risks and benefits of vertebral disc replacement in these patients).

For more on the treatment of low back pain, read here.

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