Guidelines

State of Oregon: Evidence-basedClinical Guidelines Project: Evaluation and Management of Low Back Pain

State of Oregon: Evidence-basedClinical Guidelines Project: Evaluation and Management of Low Back Pain A Clinical Practice Guideline Based on the Joint Practice Guideline of the American College of Physicians and the American Pain Society (Diagnosis and Treatment of Low Back Pain) October 2011 PDF: Evaluation & Management of Low Back Pain (October 2011)

European Guidelines for the Management of Acute Non-Specific Low Back Pain in Primary Care

GUIDELINES FOR ACUTE NONSPECIFIC LOW BACK PAIN Based on systematic reviews and existing clinical guidelines Summary of recommendations for diagnosis of acute non-specific low back pain: • Case history and brief examination should be carried out • If history taking indicates possible serious spinal pathology or nerve root syndrome, carry out more extensive physical examination including neurological […]

Impact of imaging guidelines on x-ray utilization among provider network chiropractors

Interrupted time series analysis André E. Bussières, DC, MSc, PhD The Spine Journal: Available online 4 October 2013 Abstract Background Context Overuse and misuse of spine x–rays for non-specific back and neck pain persists among chiropractors. Distribution of educational materials among physicians results in small to modest improvements in appropriate care such as ordering spine […]

Impact of imaging guidelines on X-ray use among American provider network chiropractors: interrupted time series analysis

Spine J. 2014 Aug 1;14(8):1501-9. doi: 10.1016/j.spinee.2013.08.051. Epub 2013 Oct 4. Bussières AE, Sales AE, Ramsay T, Hilles SM, Grimshaw JM. Abstract BACKGROUND CONTEXT: Overuse and misuse of spine X-ray imaging for nonspecific back and neck pain persists among chiropractors. Distribution of educational materials among physicians results in small-to-modest improvements in appropriate care, such as […]

Worsening Trends in the Management and Treatment of Back Pain

John N. Mafi, MD JAMA Intern Med. 2013;173(17):1573-1581. doi:10.1001/jamainternmed.2013.8992 September 23, 2013, Vol 173, No. 17 > ABSTRACT Importance Back pain treatment is costly and frequently includes overuse of treatments that are unsupported by clinical guidelines. Few studies have evaluated recent national trends in guideline adherence of spine-related care. Objective To characterize the treatment of […]

Back Pain Remains Overtreated

The New York Times By NICHOLAS BAKALAR AUGUST 2, 2013 Well-established guidelines for the treatment of back pain require very conservative management — in most cases, no more than aspirin or acetaminophen (Tylenol) and physical therapy. Advanced imaging procedures, narcotics and referrals to other physicians are recommended only for the most refractory cases or those with serious […]

Back Pain Tx Not Syncing with Guidelines

7/29/2013 by Cole Petrochko Staff Writer, MedPage Today   Action Points Trends in back pain management strategies in the U.S. are “discordant” with current guidelines. Point out that over the 12-year study, use of narcotics rose from 19.3% to 29.1% and imagining with CT or MRI rose from 7.2% to 11.3%. Trends in back pain […]

Management of Low Back Pain in General Practice – Is It of Acceptable Quality

An Observational Study Among 25 General Practices in South Tyrol (Italy) Giuliano Piccoliori; Adolf Engl; Doris Gatterer; Emiliano Sessa; Jürgen in der Schmitten; Heinz-Harald Abholz BMC Fam Pract. 2013;14(148) Abstract Background: There are several guidelines dealing with the management of low back pain (LBP), but only few studies on the quality of care provided within […]

Evidence for Policy Making: Clinical Appropriateness Study of Lumbar Spine MRI Prescriptions Using RAND Appropriateness Method.

Int J Health Policy Manag. 2013 Apr 10;1(1):17-21. doi: 10.15171/ijhpm.2013.04. eCollection 2013. Salari H1, Ostovar R2, Esfandiari A1, Keshtkaran A3, Akbari Sari A4, Yousefi Manesh H5, Rakhshan A6. Abstract BACKGROUND: MRI is a new and expensive diagnostic technology, which has been used increasingly all over the world. Low back pain is a worldwide prevalent disorder […]

Guidance Statement From ACP Nixes Routine PSA Testing

Medscape Medical News > Oncology Guidance Statement From ACP Nixes Routine PSA Testing Roxanne Nelson April 08, 2013 For most men, the benefits of screening with the prostate-specific antigen (PSA) test are outweighed by the harms, according to new recommendations from the American College of Physicians (ACP). The guidelines note that physicians need to inform […]

Clinical Practice Guidelines for Hypothyroidism In Adults

Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association Jeffrey R. Garber, MD, FACP, FACE; Rhoda H. Cobin, MD, FACP, MACE; Hossein Gharib, MD, MACP, MACE; James V. Hennessey, MD, FACP; Irwin Klein, MD, FACP; Jeffrey I. Mechanick, MD, FACP, FACE, FACN; Rachel Pessah-Pollack, MD; Peter A. Singer, MD, FACE; Kenneth […]

The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study

Spine J. 2010 Dec;10(12):1055-64. doi: 10.1016/j.spinee.2010.08.019. The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. Bishop PB, Quon JA, Fisher CG, Dvorak MF. Abstract BACKGROUND CONTEXT: Evidence-based clinical practice guidelines (CPGs) […]

Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines.

Spine J. 2010 Jun;10(6):514-29. doi: 10.1016/j.spinee.2010.03.032. Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines. Dagenais S, Tricco AC, Haldeman S. Abstract BACKGROUND CONTEXT: Low back pain (LBP) is a prevalent, costly, and challenging condition to manage. Clinicians must choose among numerous assessment and management options. Several […]

GPs Not Following Guidelines for Acute Low Back Pain

Low Back Pain and Best Practice Care A Survey of General Practice Physicians  Christopher M. Williams, MAppSc Arch Intern Med. 2010;170(3):271-277. doi:10.1001/archinternmed.2009.507. ABSTRACT Background Acute low back pain (LBP) is primarily managed in general practice. We aimed to describe the usual care provided by general practitioners (GPs) and to compare this with recommendations of best […]

NICE Clinical Guidelines – Low Back Pain – 2009

Early management of persistent non-specific low back pain Issued: May 2009 guidance.nice.org.uk/cg88 This guideline covers the early treatment and management of persistent or recurrent low back pain, defined as non-specific low back pain that has lasted for more than 6 weeks, but for less than 12 months. It does not address the management of severe […]

Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society

Roger Chou, MD Ann Intern Med. 2007;147(7):478-491. doi:10.7326/0003-4819-147-7-200710020-00006 2 October 2007, Vol 147, No. 7 Recommendation 1: Clinicians should conduct a focused history and physical examination to help place patients with low back pain into 1 of 3 broad categories: nonspecific low back pain, back pain potentially associated with radiculopathy or spinal stenosis, or back […]

The biochemical origin of pain: The origin of all pain is inflammation and the inflammatory response

The biochemical origin of pain: The origin of all pain is inflammation and the inflammatory response. Part 2 of 3 – Inflammatory profile of pain syndromes Sota Omoigui Division of Inflammation and Pain Research, L.A Pain Clinic, 4019 W. Rosecrans Avenue, Los Angeles, CA 90250, United States Published Online: August 29, 2007 Summary Every pain […]

Philadelphia Panel Evidence-Based Clinical Practice Guidelines on Selected Rehabilitation Interventions for Low Back Pain – 2001

John Albright, MD, Clinical Specialty Expert Physical Therapy October 2001 vol. 81 no. 10 1641-1674 Abstract Introduction. A structured and rigorous methodology was developed for the formulation of evidence-based clinical practice guidelines (EBCPGs), then was used to develop EBCPGs for selected rehabilitation interventions for the management of low back pain. Methods. Evidence from randomized controlled […]

Clinical Guidelines for the management of Acute Low Back Pain – Royal College of General Practitioners Review – 1999

Waddell G, McIntosh A, Hutchinson A, Feder G, Lewis M, (1999) Low Back Pain Evidence Review London: Royal College of General Practitioners There is now a considerable weight of evidence, linked with international experience, to show that clinical guidelines are only likely to influence practice if these guidelines form part of an implementation programme. In […]

Acute Low Back Problems in Adults – AHCPR Clinical Practice Guidelines – 1994 update 2012

AHCPR Clinical Practice Guidelines, No. 14 S Bigos, O Bowyer, and G Braen. Rockville (MD): Agency for Health Care Policy and Research (AHCPR); December 1994. Report No.: 95-0642 Findings and recommendations on the assessment and treatment of adults with acute low back problems-activity limitations due to symptoms in the low back and/or back-related leg symptoms […]