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Manipulative Therapies: What Works - American Family Physician

Feb 15, 2019 - Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p248.html

Common Questions About Chronic Low Back Pain - American Family Physician

May 15, 2015 - More than 30% of U.S. adults report having experienced low back pain within the preceding three months. Although most low back pain is nonspecific and self-limiting, a subset of patients develop chronic low back pain, defined as persistent symptoms for longer than three months. Low back...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p708.html

Gabapentin for Treatment of Radicular Low Back Pain - FPIN's Clinical Inquiries - ...

Sep 1, 2019 - Gabapentin is not effective for the treatment of radicular low back pain and is associated with adverse effects.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0901/p309.html

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.html

Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices - American Family ...

Oct 1, 2008 - Acute lumbar disk herniations are the most common cause of sciatica. After excluding emergent causes, such as cauda equina syndrome, epidural abscess, fracture, or malignancy, a six-week trial of conservative management is indicated. Patients should be advised to stay active. If ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1001/p835.html

Osteopathic Manipulative Treatment: A Primary Care Approach - Editorials - American ...

Feb 15, 2019 - Osteopathic manipulative treatment is a valuable modality that has the potential to decrease cost and improve pain/function in patients.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0215/p214.html

Physical Therapy for Low Back Pain - FPIN's Clinical Inquiries - American Family Physician

Jul 15, 2018 - There is some evidence that early physical therapy may decrease posttreatment health care utilization for low back pain.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/0715/p115.html

Lumbar Fusion of Variable Value Based on Treating Diagnosis, with Significant ...

May 1, 2018 - Lumbar fusion for degenerative spinal disease appears to be most beneficial for patients undergoing the procedure for spondylolisthesis, but it is of little clear benefit for patients with other indications, such as spinal stenosis or chronic back pain.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p605a.html

Early PT for Acute Low Back Pain Is Cost-Effective, but Gain in Quality of Life Is ...

Apr 1, 2018 - At $30,000 per quality-adjusted life year (QALY) gained, early PT for acute low back pain in primary care is cost-effective by the usual criteria of $50,000 to $100,000 per QALY. However, the magnitude of improvement in quality of life is small and is probably not clinically meaningful.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p475.html

Low Back Pain: American College of Physicians Practice Guideline on Noninvasive ...

Sep 15, 2017 - The American College of Physicians has released a guideline, which partially updates its 2007 guideline, to provide recommendations for noninvasive treatment of acute (duration less than four weeks), subacute (duration of four to 12 weeks), and chronic (duration longer than 12 weeks) ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0915/p407.html

Gabapentinoids for Chronic Low Back Pain: Limited Evidence, More Harm Than Benefit - ...

Dec 15, 2017 - The existing data on gabapentinoids for chronic low back pain are limited in number and quality. The amount of pain reduction is low to moderate, and the rate of adverse effects is high. The few studies that assessed function found no improvement.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od3.html

Noninvasive Treatments for Low Back Pain - Implementing AHRQ Effective Health Care ...

Sep 1, 2017 - What are the benefits and harms of noninvasive treatments for acute, subacute, and chronic low back pain?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/0901/p324.html

Evaluation and Treatment of Acute Low Back Pain - American Family Physician

Apr 15, 2007 - Acute low back pain with or without sciatica usually is self-limited and has no serious underlying pathology. For most patients, reassurance, pain medications, and advice to stay active are sufficient. A more thorough evaluation is required in selected patients with

American Family Physician : Article

https://www.aafp.org/afp/2007/0415/p1181.html

Pregabalin Does Not Decrease the Pain of Sciatica - POEMs - American Family Physician

Aug 15, 2017 - Pregabalin does not relieve pain in patients with sciatica.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260.html

Placebo Plus Message of Benefit Decreases Chronic Low Back Pain - POEMs - American ...

Apr 1, 2017 - These investigators gave twice daily placebo to patients with chronic back pain and told them it was placebo. They also told them that placebos can have a pronounced effect (which is true). The addition of placebo to usual care improved patients' pain and disability scores over the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p456.html

Cyclobenzaprine in the Treatment of Low Back Pain - Medicine by the Numbers - American ...

Feb 1, 2016 - Studies show that 1 in 3 patients experiences global improvement in back pain symptoms at 10 days, while 1 in 4 patients experiences medication adverse effects. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0201/od2.html

Clinical Evaluation and Treatment Options for Herniated Lumbar Disc - American Family ...

Feb 1, 1999 - Degeneration of the intervertebral disc from a combination of factors can result in herniation, particularly at the L4-5 and L5-S1 levels. The presence of pain, radiculopathy and other symptoms depends on the site and degree of herniation. A detailed history and careful physical ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0201/p575.html

Lumbar Fusion No Better Than Exercise and Therapy in the Long Term - POEMs - American ...

Dec 1, 2016 - This trial is a good example of how to do just about everything wrong to get the results you want. The authors did not conceal allocation, did not mask anyone in the study, used an unvalidated and subjective primary outcome, and downplayed the intention-to-treat analysis. Funding for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1201/p937.html

Naproxen Alone May Be Best for Acute Low Back Pain - POEMs - American Family Physician

Feb 15, 2016 - Naproxen alone is as effective as naproxen plus oxycodone/acetaminophen or naproxen plus cyclobenzaprine (Flexeril) in reducing pain and improving function in adults with acute musculoskeletal LBP without radicular symptoms. Adverse events were significantly more common in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p316.html

Pilates for the Treatment of Low Back Pain - Cochrane for Clinicians - American Family ...

Apr 1, 2016 - There is low- to moderate-quality evidence that Pilates exercises taught by certified instructors improve pain and reduce disability in patients with chronic low back pain. It is unclear whether a Pilates regimen is superior to other exercise plans for the treatment of low back pain. ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0401/p556.html

Epidural Steroid Not Better Than Placebo Injection for Sciatica and Spinal Stenosis ...

Feb 15, 2016 - It is hard to figure out what to do with these results. On the one hand, steroid injection did not provide a significant benefit compared with placebo injection in patients with radicular pain or spinal stenosis. However, part of the reason for this may be the significant and sustained ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315a.html

Treatments for Sciatica - FPIN's Clinical Inquiries - American Family Physician

May 1, 2015 - Surgical diskectomy can be offered to patients with refractory sciatica, but there is only modest, short-term improvement in leg pain and disability scores. Epidural steroid injections may be offered to patients with sciatica of more than six months' duration.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0501/p612.html

Gabapentin Equals Epidural Steroid for Radicular Pain - POEMs - American Family Physician

Nov 1, 2015 - After controlling for the placebo effect that may accompany an epidural steroid injection, treatment with gabapentin is as effective as the injection in reducing radicular leg pain in the short term (three months). A placebo bump in response, if present, is likely to be transient.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814a.html

Spinal Stenosis: Physical Therapy Before Surgery - POEMs - American Family Physician

Sep 15, 2015 - Assigning patients to six weeks of physical therapy is as effective as initially sending them for decompression surgery, with fewer complications, even in patients who have a strong preference for surgery. A trial of six weeks of physical therapy makes sense for many patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p528.html

Walking Program Effective for Chronic Low Back Pain - POEMs - American Family Physician

Aug 1, 2015 - Giving patients a pedometer, a walking diary, and instructions to walk at least four days per week, then gradually increase the walk's duration and intensity (see synopsis) results in improvement in pain and disability similar to usual physical therapy or a group exercise program.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0801/p230.html

Opioids for Chronic Back Pain: Short-Term Effectiveness, Long-Term Uncertain - POEMs - ...

Aug 15, 2014 - Overall, in patients with chronic low-back pain, opioids are moderately more effective than placebo in the short term for pain relief and slightly more effective in the short term for improving function. However, data for long-term use are virtually nonexistent. The long-term use of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0815/od5.html

Is Spinal Manipulation an Effective Treatment for Low Back Pain? Yes: Spinal ...

Apr 15, 2012 - Yes: Spinal Manipulation Is a Useful Adjunct Therapy. Spinal manipulation is one of many potential treatment options that have been used by many different types of clinicians for more than a century. Only in the past 50 years have research studies evaluated the benefits of spinal ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2012/0415/p760.html

Is Spinal Manipulation an Effective Treatment for Low Back Pain? Yes: Evidence Shows ...

Apr 15, 2012 - Yes: Evidence Shows Benefit in Most Patients. The goal of manipulation is to restore maximal, pain-free movement of the musculoskeletal system in postural balance. In the past decade, there has been a significant growth in evidence supporting the benefits of manipulation.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2012/0415/p756.html

Is Spinal Manipulation an Effective Treatment for Low Back Pain? No: Evidence Shows No ...

Apr 15, 2012 - No: Evidence Shows No Clinically Significant Benefit Over Watchful Waiting. The pain often improves greatly within one month, with more than 90 percent of patients no longer needing medical care within three months.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2012/0415/p763.html

Low Back Pain (Chronic) - Clinical Evidence Handbook - American Family Physician

Aug 15, 2011 - What are the effects of oral drug treatments, injection therapy, and nondrug treatments for persons with chronic low back pain? What are the effects of nonsurgical and surgical treatments?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2011/0815/p437.html

Antidepressants to Treat Nonspecific Low Back Pain - Cochrane for Clinicians - American...

Jul 1, 2008 - Although antidepressants have been shown to be superior to placebo in some forms of chronic pain, they do not reduce pain or improve functional status or depression in patients with nonspecific low back pain.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2008/0701/p51.html

Treatment of Acute Sciatica - FPIN's Clinical Inquiries - American Family Physician

Jan 1, 2007 - In patients with acute sciatica, bed rest and advice to stay active have similar outcomes on their functional status and perceived improvement.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/0101/p99.html

Chronic Low Back Pain - Clinical Evidence Handbook - American Family Physician

Nov 1, 2006 - What are the effects of nondrug and oral drug treatments and injection therapy?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2006/1101/p1577.html

Acute Low Back Pain - Clinical Evidence Handbook - American Family Physician

Sep 1, 2006 - What are the effects of oral drug and nondrug treatments? What are the effects of local injections?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2006/0901/p803.html

Herniated Lumbar Disk - Clinical Evidence Handbook - American Family Physician

Apr 1, 2006 - What are the effects of surgery and drug and nondrug treatments?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2006/0401/p1240.html

Spinal Manipulative Therapy for Low Back Pain - Cochrane for Clinicians - American ...

Feb 1, 2005 - In the short term, manipulative therapy is as effective for acute or chronic low back pain as other treatments such as analgesics, physical therapy, exercises, back school, and routine care from a primary care physician. Radiation of pain, type of manipulation, and use of multiple ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2005/0201/p464.html

Do NSAIDs Help in Acute or Chronic Low Back Pain? - Cochrane for Clinicians - American ...

Apr 1, 2002 - Patients can expect a modest improvement in global function with NSAID therapy, such as ibuprofen. There is no evidence that any particular NSAID or combination of medicines has superior efficacy in the treatment of low back pain.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2002/0401/p1319.html

Low Back Pain - Clinical Evidence Handbook - American Family Physician

Mar 1, 2002 - What are the effects of oral drug treatments for low back pain? What are the effects of local injections for low back pain? What are the effects of nondrug treatments for low back pain?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2002/0301/p925.html

The Care of Low Back Problems: Less Is More - Editorials - American Family Physician

Jun 1, 2002 - Advertisement << Previous article Next article >> Jun 1, 2002 Issue Editorial The Care of Low Back Problems: Less Is More JEFF SUSMAN, M.D. University of Cincinnati College of Medicine Cincinnati, Ohio Am Fam Physician. 2002 Jun 1;65(11):2217-2218. Related Article In this issue of...

American Family Physician : Editorials

https://www.aafp.org/afp/2002/0601/p2217.html

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