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Diagnosis and Treatment of Low Back Pain

By: Dr. Donna A. Pontoriero, Chiropractor

The American College of Physicians and the American Pain Society have issued a Joint Clinical Practice Guideline. The key recommendation: "For patients who do not improve with self-care options, clinicians should consider the addition of 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."

The research supporting this recommendation: Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline (Cho and Huffman, Annals of Internal Medicine, 2007) found "Good evidence that cognitive-behavioral therapy, exercise, spinal manipulation, and interdisciplinary rehabilitation are all moderately effective for chronic or subacute (longer than 4 weeks duration) low back pain."

Also cited was efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence sythesis (Spine Journal May-June 2004.)

"For acute low back pain (less than 4 weeks' duration), the only nonpharmacologic therapies with evidence of efficacy are superficial heat and spinal manipulation."

Please contact our office if you would like further evaluation on your condition.

Dr. Donna Pontoriero can be reached at 299 Franklin Ave, Nutley NJ 07110, 973-235-9393.