May 14, 2018 · Chiropractic

Recommended Plan of Management for Low Back Pain (LBP)

Archived article recovered from the former Rupert Health Centre WordPress blog. It is presented for historical information and has not been updated; it is not personal medical advice.

Educate on nature and course of LBP, provide reassurance, and advise on physical activity and self-management strategies. Based on patient preference and practitioner experience, we suggest:

Acute (0-3 months) Low Back Pain

• Spinal Manipulative Therapy (SMT), other commonly used treatments or a combination of SMT and commonly used treatments to decrease pain and disability in the short term.      

Remark: Other commonly used treatments may include advice on posture and physical activity, and usual medical care when deemed beneficial.

Chronic ( > 3 months) Low Back Pain

• Spinal Manipulative Therapy (SMT) over minimal intervention to decrease pain and disability in the short term.

Remark: Minimal intervention includes manually applied forces with diminished magnitude or 5-minute light massage.

• Spinal Manipulative Therapy (SMT) or other treatments for short-term reduction in pain and disability.

Remark: Other treatments include extension exercises, advice plus exercise, myofascial therapy, or usual medical care when deemed beneficial. Pain relief is most effective within the first 6 months and functional improvement was most effective at 1 month.

• Multimodal therapy with or without Spinal Manipulative Therapy (SMT) to decrease pain and disability.

Remark: Multimodal therapy with SMT treatment may also include exercise, myofascial therapy, advice, educational material, usual medical care when deemed beneficial. SMT (2 sessions per week for 4 weeks) plus standard medical therapy has shown better pain and functional outcomes than standard medical care alone. Pain and functional improvement was also shown at 3 and 12 months.

Chronic ( > 3 months) Back-Related Leg Pain (Sciatica or Radicular Low Back Pain)

• Spinal Manipulative Therapy (SMT) plus home exercise and advice to reduce back pain and disability.

Remark: Reduced chronic back-related leg pain (sciatica or radicular LBP) and disability were observed at 12 weeks follow-up. Home exercise includes positioning and stabilization exercises.

Canadian Chiropractic Guideline Initiative

www.chiroguidelines.org

Questions about your symptoms? Book an assessment or call 604.435.2285.