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. 2010 Nov-Dec;15(6):392–400. doi: 10.1155/2010/252695

TABLE 1.

Summary of diagnostic and treatment recommendations for low back pain from 11 international guidelines

Diagnosis

Diagnostic triage to classify patients as having nonspecific low back pain, specific low back pain or sciatica/radicular syndrome
History taking and physical examination to exclude red flags (findings that suggest a serious pathology such as cancer)
Neurological screening
Radiography is not useful and should be restricted to patients with red flag indications
Psychosocial factors should be considered if there is no improvement
Treatment

Acute or subacute pain
  Provide information and reassurance to the patient
  Advise to stay active and progressively increase activity level
  Prescribe medication if necessary (time contingent): First choice acetaminophen, second choice nonsteroidal anti-inflammatory drugs; consider muscle relaxants or opioids
  Discourage bed rest; if needed for pain severity, then restrict to no more than a few days
  Consider spinal manipulation for pain relief
  Do not advise back-specific exercises
  Only refer to a specialist if a red flag, sciatica/radicular syndrome or a neurological problem is present
Chronic pain
  Refer for exercise therapy

Data from reference 16