Acute Low Back Pain (0 to 4 Weeks)
*symptomatic relief with NSAIDs or acetaminophen
*symptomatic relief with NSAIDs or acetaminophen
*activity advice recommending return to normal activities as soon as tolerable
*short-term opioid
*muscle relaxant for as long as 1 to 2 weeks
*education of the patient regarding the generally favorable natural history of the problem
Subacute Low Back Pain (4 to 12 Weeks)
*reevaluation
*appropriate laboratory and imaging studies
*active exercise-oriented physical therapy is recommended both for its reconditioning and educational benefits
Chronic Low Back Pain (More than 12 Weeks)
*interventional investigation may identify a potential precise pain generator
*Exercise improves pain intensity and functional status in persons with chronic back pain and is the cornerstone of management
*Pure analgesics
*Tricyclic antidepressants may be useful as adjuvant analgesics
*Manipulation, acupuncture, or massage may be of some benefit as adjunctive treatment in selected patients with chronic back pain
*education
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