Back Pain, Acute Low back pain without radiculopathy

Clinic A/P, adults, Clinic A/P, Peds

Diagnosis
H & P consistent with low back pain.
-No red flags.

Treatment
NSAIDs and acetaminophen, separate or combined.
Muscle relaxants (e.g. cyclobenzaprine, baclofen).
Diclofenac (Voltaren) gel if oral NSAIDs contraindicated.
Apply ice or heat.
Physical therapy.
Early ambulation. Discourage bed rest.
Patient education.

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  • “Nonbenzodiazepine muscle relaxants such as cyclobenzaprine are beneficial for the relief of acute low back pain for the first 7–14 days after the onset of symptoms.”
  • There is no evidence that lumbar support is helpful in back pain.

Reference

Casazza BA: Diagnosis and treatment of acute low back pain. Am Fam Physician 2012;85(4):343-350.

Am Fam Physician. 2007 Apr 15;75(8):1181-1188. https://www.aafp.org/afp/2007/0415/p1181.html

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