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New clinical guideline for low-back pain
Date:10/2/2007

A summary of evidence on the diagnosis and treatment of low-back pain has prompted the American Pain Society (ASP) and the American College of Physicians (ACP) to issue a new treatment guideline. The guideline is based on a thorough analysis of published research conducted by investigators at the Oregon Evidence-Based Practice Center at Oregon Health & Science University.

Among the recommendations issued by a panel of experts convened by the ACP and ASP are: Clinicians should rely less on X-rays and expensive diagnostic imaging and reports and more on therapies support by the evidence, including some medications and some alternative therapies. The guideline and two background papers are published in the October issue of the Annals of Internal Medicine.

There is good evidence that clinicians should not order X-rays or other imaging tests for patients with nonspecific low-back pain. They are not helpful and could result in excessive radiation exposure or unnecessary procedures, said Roger Chou, M.D., co-author of the new guidelines, senior author of both background papers, and associate professor of medicine (general internal medicine and geriatrics) and medical informatics and clinical epidemiology in the OHSU School of Medicine, Oregon Evidence-Based Practice Center at OHSU.

That said, clinicians should order diagnostic imaging tests for patients known or believed to have underlying neurological or spinal disorders, Chou explained. Chou also is head of the American Pain Societys Clinical Practice Guideline Program.

About one if four Americans experiences low-back pain at least once a day, resulting in more than $26 billion in direct health care costs, studies have shown. And low-back pain is the fifth most common reason patients make a doctors appointment.

The new guideline recommends clinicians weigh carefully potential benefits and risks of any drug and explain that they be used based on the severity of baseline pa
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Contact: Tamara Hargens-Bradley
hargenst@ohsu.edu
503-494-8231
Oregon Health & Science University
Source:Eurekalert

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