Oct 26 2007
Backpain without surgery
People with backpain live in their own world a lot of the time. Waiting and hoping for some relief. The American College of Physicians have published guidelines for the management of their case:
1. Physical exam and focused history, including assessment of psychosocial risk factors for chronic disabling back pain, to categorize patients as having nonspecific back pain, radiculopathy or spinal stenosis, or pain with another specific spinal cause
2. No routine imaging or other diagnostic tests for patients with nonspecific back pain
3. Imaging and other relevant diagnostic testing for patients with severe or progressive neurologic deficits or when serious underlying conditions are suspected
4. Imaging (preferably magnetic resonance) for evaluation of persistent pain, radiculopathy, or spinal stenosis only when patients are being considered for surgery or epidural steroid injection
5. Providing patients with prognostic information and self-care options (written information, remain active, superficial heat)
6. Use of acetaminophen or nonsteroidal anti-inflammatory drugs as first-line medication, depending on pain severity and physical dysfunction while considering lack of long-term efficacy
7. Nonpharmacologic therapy for patients who do not improve with self-care alone: spinal manipulation for acute pain; intensive interdisciplinary rehabilitation, exercise therapy, yoga, cognitive behavioral therapy, or progressive relaxation for chronic pain.
If you are a patient: check this list and make sure they think in the same way.
