LOWBACK GUIDELINES
 
   

Lowback Guidelines

This section was compiled by Frank M. Painter, D.C.
Send all comments or additions to:
  Frankp@chiro.org


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Diagnosis and Treatment of Low Back Pain:   A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society
Annals of Internal Medicine 2007 (Oct 2);   147 (7):   478–491 ~ FULL TEXT

Low back pain is the fifth most common reason for all physician visits in the United States [1, 2]. Approximately one quarter of U.S. adults reported having low back pain lasting at least 1 whole day in the past 3 months [2], and 7.6% reported at least 1 episode of severe acute low back pain (see Glossary) within a 1-year period [3]. Low back pain is also very costly: Total incremental direct health care costs attributable to low back pain in the U.S. were estimated at $26.3 billion in 1998 [4]. In addition, 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 [5]. You will enjoy these recommendations because their ONLY recommendation for active treatment of acute low back pain is spinal adjusting (manipulation).


   Chiropractic Management of Low Back Pain and Low Back Related
Leg Complaints

Research Commission of the Council of Chiropractic Guidelines and Practice Parameters
This Long-awaited Low Back Pain Guideline is now ready for your review.
You may also be interested in reading the COCSA statement That Advises State Associations to Take Active Roll in Best Practices Development Process


  
Low-Back Pain:   Frequency, Management and Prevention
           The Danish Institute for Health Technology Assessment (DIHTA) describes LBP, then labels treatments in 3 categories: Generally recommended, recommended in certain conditions, or not recommended. The FIRST recommended "treatment" is manual therapy (which includes chiropractic).


   Chiropractic Management of Low Back Pain and Low Back Related
Leg Complaints

Research Commission of the Council of Chiropractic Guidelines and Practice Parameters
This Long-awaited Low Back Pain Guideline is now ready for your review.
You may also be interested in reading the COCSA statement That Advises State Associations to Take Active Roll in Best Practices Development Process


  
Pran Manga Guidelines
           Includes the original 1993 and the updated 1998 recommendations to the Canadian Government about inclusion of chiropractic in their Health Care System.


   Royal College of General Practitioners
Clinical Guidelines for the Management of Acute Low Back Pain

This is Britian's follow-up to:   Bigos, Stanley J et al. "Acute Low Back Problems in Adults" released December 2001. Their comments on spinal manipulation were: "In acute and sub-acute back pain, manipulation provides better short-term improvement in pain and activity levels and higher patient satisfaction than the treatments to which it has been compared." AND "The risks of manipulation for low back pain are very low, provided patients are selected and assessed properly and it is carried out by a trained therapist or practitioner. Manipulation should not be used in patients with severe or progressive neurological deficit in view of the rare but serious risk of neurological complication. "


  
British Occupational Health Guidelines for the Management of Low Back Pain at Work –– Principal Recommendations
Faculty of Occupational Medicine, London; 2000

Disability from back pain in people of working age is one of the most dramatic failures of health care in recent years. Its greatest impact is on the lives of those affected and their families. This review and the guidelines based on it aim to reduce the toll of harm by providing a new approach to back pain management at work which is based on the best available scientific evidence and uses this to make practical recommendations on how to tackle the occupational health aspects of the problem.


  
Chiropractic Care for Common Industrial Low Back Conditions
           Chiropractic Technique 1993 (Aug);   5 (3):   119–125 ~ FULL TEXT

           This is the first guideline I have seen which actually states the number of visits which may be appropriate for a variety of common low back conditions.   I have used these "care plans" for years, presenting them to third party's as a "working diagnosis" care plan, which need ongoing "fine tuning" during patient care. Check out this Chiropractic Technique article, and the attached care plans, which have been released exclusively to Chiro.Org by the National College of Chiropractic. Thanks, Dana! You will find other information like this in the GUIDELINES Section.

Download the “Care Plans” –   in Word 97 Format   or

in Adobe Acrobat Format

They are formatted, so you can add your own letterhead and mail them out to claim adjusters tomorrow! Just use "save-as" and they are all yours!      Download The Adobe Acrobat Reader for Free


   Guidelines for Chiropractic Quality Assurance and Practice Parameters
-- Major Recommendations

Aspen Publishers, Inc; 1993

This outline of the "Mercy Center" Consensus Statement covers history and exam, diagnostic imaging, instrumentation (including Questionnaires, Algometry, Inclinometers and Thermography), clinical laboratory recommendations, and a detailed section on record keeping and patient consent. You can purchase a copy of it right here


   Guide to Assessing Psychosocial Yellow Flags in Acute Low Back Pain: Risk Factors for Long–Term Disability and Work Loss
New Zealand Guidelines Group

This guide is to be used in conjunction with the New Zealand Acute Low Back Pain Guide. It provides an overview of risk factors for long–term disability and work loss, and an outline of methods to assess these at risk. Identification should lead to appropriate early management targeted towards the prevention of chronic pain and disability.


   Evaluation of the Low Back Industrial Injury
            From the California Industrial Medical Council.   Low back problems are common among workers. In the majority of injured workers with low back problems, recovery occurs within the first month of symptoms. Those who have not improved at the end of one month of treatment may need further diagnostic evaluation and consideration of other treatment options. Management of low back problems in injured workers includes consideration of environmental and personal factors which may be causing or aggravating the problem, as well as providing appropriate treatment that leads to a return to productive work.

 
   

AHCPR's "Acute Low Back Problems in Adults" Series   
 
   

   Acute Low Back Problems in Adults (Clinical Guide)
            Bigos, Stanley J et al.
            December 1994 (AHCPR Publication No. 95–0642).
            U.S. Agency for Health Care Policy and Research

   Acute Low Back Problems in Adults (Quick Reference Guide)
            Bigos, Stanley J et al.
            December 1994 (AHCPR Publication No. 95–0643).
            U.S. Agency for Health Care Policy and Research



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Updated 7-23-2009

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