文档介绍：Clinical Guidelines
Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice
Guideline from the American College of Physicians and the American
Pain Society
Roger Chou, MD; Amir Qaseem, MD, PhD, MHA; Vincenza Snow, MD; Donald Casey, MD, MPH, MBA; J. Thomas Cross Jr., MD, MPH;
Paul Shekelle, MD, PhD; and Douglas K. Owens, MD, MS, for the Clinical Efficacy Assessment mittee of the American College of
Physicians and the American College of Physicians/American Pain Society Low Back Pain Guidelines Panel*
mendation 1: Clinicians should conduct a focused history mendation 5: Clinicians should provide patients with evi-
and physical examination to help place patients with low back pain dence-based information on low back pain with regard to their
into 1 of 3 broad categories: nonspecific low back pain, back pain expected course, advise patients to remain active, and provide
potentially associated with radiculopathy or spinal stenosis, or back information about effective self-care options (strong menda-
pain potentially associated with another specific spinal cause. The tion, moderate-quality evidence).
history should include assessment of psychosocial risk factors, which
mendation 6: For patients with low back pain, clinicians
predict risk for chronic disabling back pain (strong mendation, should consider the use of medications with proven benefits in
moderate-quality evidence). conjunction with back care information and self-care. Clinicians
mendation 2: Clinicians should not routinely obtain imaging should assess severity of baseline pain and functional deficits, po-
tential benefits, risks, and relative lack of long-term efficacy and
or other diagnostic tests in patients with nonspecific low back pain
safety data before initiating therapy (strong mendation, mod-
(strong mendation, moderate-quality evidence).
erate-quality evidence). For most patients, first-line medication op-
mendation 3: Clinicians should perform diagnostic imaging