Back pain often over-treated

The Sydney University researchers, led by Mark Hancock from the University of Sydney Back Pain Research Group, followed 240 patients suffering from acute low back pain from their first visit to their GP through to recovery.

Current guidelines for the treatment of acute low back pain recommend that GPs provide advice (to remain active, avoid bed rest etc) and paracetamol as the first line of care. Non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac and spinal manipulation are then recommended as second line management options.

'It is therefore particularly important to establish the efficacy of using NSAIDs in view of recent concerns about potential adverse with these drugs,' said Mark.

'Although lumbar spinal manipulation is also associated with adverse events, the main concern we have in this area is the requirement of referral and extra expense for this treatment,' he said.

Results from the study showed that neither diclofenac (a commonly prescribed NSAID) nor spinal manipulation provided clinically useful effects with regard to the time to recovery.

'We therefore concluded that patients with acute low back pain should be treated according to international guidelines without diclofenac or spinal manipulation,' said Mark.

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