scholarly journals Diagnostic and treatment algorithms for acute low back pain

2021 ◽  
pp. 63-70
Author(s):  
V. A. Golovacheva ◽  
A. A. Golovacheva
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Practical Importance ◽  
Favorable Effect ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Pain Syndromes ◽  
Therapeutic Exercises ◽  
Inflammatory Drugs

Low back pain (LBP) is one of the most common reasons to see a physician. In 90–95% of cases, LBP is nonspecific (musculoskeletal). Timely diagnosis of acute nonspecific LBP and its effective treatment are of practical importance, have a favorable effect on the prognosis of recovery and significantly reduce the risk of chronic pain. The diagnosis of acute nonspecific LBP is established on the basis of complaints, clinical picture, data of somatic and neurological examination, absence of “red flags” (symptoms and signs characteristic of specific causes of back pain, discogenic radiculopathy or lumbar stenosis). Drug and non-drug methods are used in the treatment of acute nonspecific LBP. In acute nonspecific LBP, great importance is attached to informing the patient about the causes of pain and a favorable prognosis, the need to stay active, avoid staying in bed and wearing corsets. As pharmacotherapy, the prescription of nonsteroidal anti-inflammatory drugs (NSAIDs) is effective. Nimesulide, an NSAID that is used to treat various pain syndromes, is effective and safe in the treatment of acute nonspecific LBP. In addition to NSAIDs, muscle relaxants and B vitamins may be prescribed. Therapeutic exercises are not prescribed during the acute period of back pain. Therapeutic exercises are effective in preventing exacerbations of LBP. We present our own clinical example of managing a patient with acute nonspecific LBP. Complex treatment based on international and Russian recommendations allowed to help her relatively quickly and effectively. The achieved positive effect was maintained for 3 months of follow-up of the patient.

Early Intervention Options for Acute Low Back Pain Patients: A Randomized Clinical Trial with One-Year Follow-Up Outcomes

2010 ◽  
Vol 20 (2) ◽  
pp. 256-263 ◽  
Author(s):  
Travis Whitfill ◽  
Robbie Haggard ◽  
Samuel M. Bierner ◽  
Glenn Pransky ◽  
Robert G. Hassett ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Early Intervention ◽  
Randomized Clinical Trial ◽  
Low Back ◽  
Acute Low Back Pain ◽  
One Year ◽  
Pain Patients

Handgrip strength is associated with, but poorly predicts, disability in older women with acute low back pain: A 12-month follow-up study

Maturitas ◽  
2017 ◽  
Vol 104 ◽  
pp. 19-23 ◽  
Author(s):  
Diogo Carvalho Felício ◽  
Juliano Bergamaschine Mata Diz ◽  
Daniele Sirineu Pereira ◽  
Bárbara Zille de Queiroz ◽  
Juscélio Pereira de Silva ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Older Women ◽  
Handgrip Strength ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Follow Up Study

scholarly journals Effectiveness of treatments for acute and subacute mechanical non-specific low back pain: a systematic review with network meta-analysis

2021 ◽  
pp. bjsports-2020-103596
Author(s):  
Silvia Gianola ◽  
Silvia Bargeri ◽  
Gabriele Del Castillo ◽  
Davide Corbetta ◽  
Andrea Turolla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Muscle Relaxants ◽  
Low Back ◽  
Eligibility Criteria ◽  
Experienced Pain ◽  
Inflammatory Drugs

ObjectiveTo assess the effectiveness of interventions for acute and subacute non-specific low back pain (NS-LBP) based on pain and disability outcomes.DesignA systematic review of the literature with network meta-analysis.Data sourcesMedline, Embase and CENTRAL databases were searched from inception until 17 October 2020.Eligibility criteria for selecting studiesRandomised clinical trials (RCTs) involving adults with NS-LBP who experienced pain for less than 6 weeks (acute) or between 6 and 12 weeks (subacute).ResultsForty-six RCTs (n=8765) were included; risk of bias was low in 9 trials (19.6%), unclear in 20 (43.5%), and high in 17 (36.9%). At immediate-term follow-up, for pain decrease, the most efficacious treatments against an inert therapy were: exercise (standardised mean difference (SMD) −1.40; 95% confidence interval (CI) −2.41 to –0.40), heat wrap (SMD −1.38; 95% CI −2.60 to –0.17), opioids (SMD −0.86; 95% CI −1.62 to –0.10), manual therapy (SMD −0.72; 95% CI −1.40 to –0.04) and non-steroidal anti-inflammatory drugs (NSAIDs) (SMD −0.53; 95% CI −0.97 to –0.09). Similar findings were confirmed for disability reduction in non-pharmacological and pharmacological networks, including muscle relaxants (SMD -0.24; 95% CI -0.43 to -0.04). Mild or moderate adverse events were reported in the opioids (65.7%), NSAIDs (54.3%) and steroids (46.9%) trial arms.ConclusionWith uncertainty of evidence, NS-LBP should be managed with non-pharmacological treatments which seem to mitigate pain and disability at immediate-term. Among pharmacological interventions, NSAIDs and muscle relaxants appear to offer the best harm–benefit balance.

scholarly journals Non-steroidal anti-inflammatory drugs for acute low back pain

2020 ◽  
Author(s):  
Wendelien H van der Gaag ◽  
Pepijn DDM Roelofs ◽  
Wendy TM Enthoven ◽  
Maurits W van Tulder ◽  
Bart W Koes
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Additional treatments for acute nonspecific lumbodynia

2019 ◽  
Vol 11 (2S) ◽  
pp. 98-102
Author(s):  
O. A. Solokha ◽  
N. V. Vashchenko
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Medical Care ◽  
Manual Therapy ◽  
Clinical Guidelines ◽  
Clinical Findings ◽  
Common Reason ◽  
Low Back ◽  
Therapeutic Exercises ◽  
Inflammatory Drugs

Low back pain (lumbodynia) is a most common reason for seeking medical care and a most common of disability. The review presents current clinical guidelines for the management of patients with acute nonspecific lumbodynia. The diagnosis of acute nonspecific lumbodynia is based on clinical findings and, in most cases, requires no instrumental studies. Nonsteroidal anti-inflammatory drugs are most effective in reducing pain. Additional therapies, such as therapeutic exercises, manual therapy, massage, acupuncture, etc., are discussed. There are data on the use of B vitamins, Milgamma® in particular, in acute non-specific lumbalgia.

scholarly journals BokSmart: Preventive rehabilitation for rugby injuries to the lower back and core

2008 ◽  
Vol 20 (4) ◽  
Author(s):  
N Hopkins
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Exercise Therapy ◽  
Weight Training ◽  
Cochrane Review ◽  
Core Stability ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Therapeutic Exercises ◽  
Spinal Flexibility

Background. The low back is an integral part of the entire movement chain as it functions as part of a complex network of the skeletal, muscular and nervous system. Eighty to 90% of acute low back pain episodes dissipate within 8 - 12 weeks regardless of any intervention, but 5 - 10% regress into chronic low back pain. As a result of its undistinguished aetiology, the treatment for low back pain remains controversial. Treatment options for low back pain include the following: analgesics, muscle relaxants, antidepressants, nonsteroidal anti-inflammatory drugs, epidural steroid injections, manipulation, back schools, electromyographic biofeedback, traction, orthoses, behaviour therapy, transcutaneous electrical nerve stimulation, acupuncture, and exercise therapy. Results. Therapeutic exercises for low back pain have been shown in 6 different randomised controlled trials to be beneficial in reducing pain by up to 60% and improving functional ability by up to 47%. Furthermore, a Cochrane review on low back pain found strong evidence that exercise therapy is an effective intervention in the treatment of low back pain. When prescribing exercises for an individual with low back pain the following goals need to be considered: (i) improve performance in endurance activities; (ii) improve muscular strength around the spine; (iii) eliminate any impairments in spinal flexibility; (iv) reduce the intensity of the pain being experienced by the individual; and (v) reduce back pain-related disability. A rugby player will have increased core stability/strength and a reduced risk of injury if the internal support mechanisms of the spine have been conditioned to resist distortion or injury from external forces. Not only will improved core  stability benefit players on the field during matches or practices, it will also assist in preventing unnecessary injuries during weight training and pre-season conditioning. Conclusion. Exercise programmes which combine core stability with general strength training should be prescribed for rugby players to prepare them for the level of impact involved in the game, as well as for sport-related weight training and non-sport-related daily activities.

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