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Low Back Pain Treatment Guidelines

Low back pain is one of the most common reasons for physician visits in the United States. Most Americans have experienced low back pain, and approximately one quarter of U.S. adults reported having low back pain lasting at least 1 day in the past 3 months (1). Low back pain is associated with high costs, including those related to health care and indirect costs from missed work or reduced productivity (2).

Acute back pain is defined as lasting less than 4 weeks, subacute back pain lasts 4 to 12 weeks, and chronic back pain lasts more than 12 weeks.

Clinical recommendations from the Annals of Internal Medicine.

Recommendation 1:

Given that most patients with acute or subacute low back pain improve over time regardless of treatment, clinicians and patients should select spinal manipulation, nonpharmacologic treatment with superficial heat, massage, or acupuncture.

Recommendation 2:

For patients with chronic low back pain, patients should initially select nonpharmacologic treatment with exercise, spinal manipulation, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, yoga, progressive relaxation, electric muscle stimulation, or low-level laser therapy.

Recommendation 3:

In patients with chronic low back pain who have had an inadequate response to nonpharmacologic therapy, clinicians and patients should consider pharmacologic treatment with nonsteroidal anti-inflammatory drugs.

If you are suffering from low back pain, the recommendations are to start conservative care first. Chiropractic has been shown to be very effective treatment option for many musculoskeletal conditions that cause pain. Dr. Gibson at RTP Chiropractic in Morrisville will evaluate your condition and come up with the most effective and conservative treatment options.


Deyo RA, Mirza SK, Martin BI, Back pain prevalence and visit rates: estimates from U.S.national surveys, 2002. Spine (Phila Pa 1976)20063127247

Andersson GB, Epidemiological features of chronic low-back pain.
Lancet 1999;354:581-5