Diagnosis and treatment of back pain.

The American College of Physicians and the American Pain Society have published their joint Clinical Practice Guideline for the diagnosis and treatment of back pain. Comprising seven recommendations it makes for fascinating reading.

The stated purpose of the guideline is to present the available evidence for evaluation and management of acute and chronic low back pain in primary care settings. The target audience is any clinician caring for patients with low back pain of any duration.

Many patients suffer self-limited episodes of acute low back pain and do not seek medical care. Among those who do pain and disability typically improve rapidly in the first month.

Low back pain is the fifth most common reason for all physician visits in the USA. Approximately one quarter of U.S. adults reported having low back pain lasting at least 1 whole day in the past 3 months.  Low back pain is also very costly. The total incremental direct health care costs attributable to low back pain in the U.S. were estimated at $26.3 billion in 1998. Indirect costs related to days lost from work are substantial with approximately 2% of the U.S. work force compensated for back injuries each year.

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