New Zealand Guidelines Group
New Zealand Guidelines Group - New Zealand Guideline - Completed

New Zealand Acute Low Back Pain Guide
Algorithm: Management of Acute Low Back Pain

Summary of management options for an episode of acute low back pain based on the evidence available at present

Evidence of Improved Clinical Outcomes
  • Advice to stay active and continue usual activities
  • Paracetamol
  • NSAIDs (non-steroidal anti-inflammatory drugs)
  • Manipulation – in the first 4 to 6 weeks only
Evidence of no improvement in clinical outcomes
  • Bed rest for more than 2 days
  • TENS (transcutaneous electrical nerve stimulation)
  • Traction
  • Specific back exercises
  • Education pamphlets about low back symptoms
Evidence of potential harm from the treatments below which should not be used
  • Use of narcotics or diazepam (especially for more than 2 weeks)
  • Bed rest with traction
  • Manipulation under general anaesthesia
  • Plaster jacket
Insufficient research evidence for any improvement in clinical outcomes
  • Conditioning exercises for the trunk muscles
  • Aerobic conditioning
  • Epidural steroid injections
  • Workplace back schools
  • Acupuncture
  • Shoe lifts
  • Corsets
  • Biofeedback
  • Physical agents and passive modalities (includes ice, heat, short wave diathermy, massage, ultra sound)

Copyright 1998–2002
New Zealand Guidelines Group
New Zealand