Acute Low Back Pain Adult (< 6 weeks)

Focused History/Physical

Identify serious disease

Identify crucial physical findings
4-6 Weeks of Conservative Care
Recommendations: stay active but avoiding heavy lifting, bending, twisting, and prolonged sitting.

NSAIDs (e.g. Naproxen 500mg) PO BID
Cyclobenzaprine 5mg PO TID short term
Acetaminophen 500-1000 mg po q4-6 hrs

PT to help short term pain relief and disability
Patient Education Handout
Treatment Options
Perform Dx. Studies to ID Cause
Further Evaluation Strategy
Continue Treatment
and
Follow up
 
Treat Cause
 
Consider Specialist or further Diagnostic Work-Up

Further Evaluation Strategy
Discuss
Treatment Options

CautionCaution

Cost preferredCost Guide

References:

1Kinkade S. Evaluation and treatment of acute low back pain. Am Fam Physician 2007;75(8):1181-1188.

2Chou R, Qaseem A, Snow V, Casey D, Cross JT, Jr., Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med 2007;147(7):478-491.

3ACP PIER & AHFS DI® Essentials. Low back pain. Philadelphia, PA: American College of Physicians; [updated 2008 Dec 8; cited 2009 Feb 5].

4Browning R, Jackson JL, O'Malley PG. Cyclobenzaprine and back pain: a meta-analysis. Arch Intern Med 2001;161(13):1613-1620.


Pathway does not replace clinical judgment and should be modified as needed for individual patients. Page last revised 10/26/09.
Please send comments to: lefevrem@health.missouri.edu

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Published by the Department of Family & Community Medicine, Columbia, MO 65211