Table 3.
Therapeutic recommendations for acute low back pain in guidelinesa
| Therapy | Recommendation, n (%) | Total guidelines, n (%) | ||||
|---|---|---|---|---|---|---|
| Use | Use in some cases | Do not use | Ambiguous | Absent | ||
| NSAIDs | 5 (45) | 6 (55) | 0 | 0 | 0 | 11 (100) |
| Non-opioid analgesics | 11 (100) | 0 | 0 | 0 | 0 | 11 (100) |
| Opioids | 0 | 3 (33) | 3 (33) | 2 (22) | 1 (11) | 9 (100) |
| Muscle relaxants | 1 (9) | 1 (9) | 6 (55) | 3 (27) | 0 | 11 (100) |
| Steroid injection (“trigger point”) | 0 | 1 (14) | 2 (28) | 1 (14) | 3 (44) | 7 (100) |
| Steroid injection (epidural) | 0 | 2 (28) | 1 (14) | 0 | 4 (58) | 7 (100) |
| Physical activity | 10 (91) | 0 | 0 | 0 | 1 (9) | 11 (100) |
| Bed rest | 0 | 2 (17) | 9 (75) | 0 | 1 (8) | 12 (100) |
| Exercises | 2 (17) | 5 (41) | 0 | 2 (17) | 3 (25) | 12 (100) |
| Education | 5 (56) | 0 | 0 | 1 (11) | 3 (33) | 9 (100) |
| Manipulation | 1 (9) | 7 (64) | 1 (9) | 1 (9) | 1 (9) | 11 (100) |
| “Back school” | 0 | 1 (10) | 1 (10) | 2 (20) | 6 (60) | 10 (100) |
| Transcutaneous electric nerve stimulation | 0 | 0 | 3 (33) | 1 (11) | 5 (55) | 9 (100) |
| Physical agents | 1 (10) | 1 (10) | 0 | 4 (40) | 4 (40) | 10 (100) |
| Lumbar corsets | 0 | 0 | 3 (33) | 0 | 6 (66) | 9 (100) |
| Acupuncture | 0 | 0 | 4 (44) | 0 | 5 (56) | 9 (100) |
| Massage | 0 | 1 (12) | 0 | 1 (12) | 6 (76) | 8 (100) |
| Biofeedback | 0 | 0 | 2 (29) | 0 | 5 (71) | 7 (100) |
| Traction | 0 | 0 | 4 (50) | 1(12) | 3 (38) | 8 (100) |
| Total | 36 (20) | 30 (17) | 39 (22) | 19 (10) | 57 (31) | 181 (100) |