AHPRC Study
The AHCPR panel
---a 23 member committee of medical doctors,nurses,chiropractic doctors,experts in spine research,physical therapists,a psychologist,an occupational therapist and a consumer representative. The guidelines suggests that a focused medical history and physical exam are sufficient to assess the patient with an acute or recurrent limitation due to low-back symptoms.And in the absence of "red flags: or indications of serious underlying spinal contitions. Treatment recommendations: 1)Acetominophen, nonsterioidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen are safe for pain control. Muscle relaxants and opiod analgesics are an option for short-term treatment, but appear to be no more effective than NSAIDs and may cause drowsiness amoung other side effects. 2)Spinal manipulation can be helpful when symptoms begin but patients should be reevaluated if there is no symptom improvement after four weeks. 3)Low stress exercise such as walking, biking, swimming, and light jogging if the problems are mild to moderate. 4)Conditioning exercises for trunk musckes can be started and gradually increased after the first two weeks of treatment. Treatments not recommeded: 1)Spinal traction, biofeedback, tens, and acupucture 2)Lumbar corsets(except when used for prevention of injuries in lifting),support belts, back machines. 3)Oral steroids, colchincine, antidepressants, and phenylbutazone whose potential side effects may as serious as none marrow suppressant. 4)Therapies involving the injection of local anesthetics, corticosterioids, or other substances into the back. Potential side effects from these therapies include nerve damaging and hemorrhaging. 5)Heat/diathermy, massage, ultrasound, cutaneous laser treatment and electrical stim.