Radiologists Develop New Guidelines for Managing Acute Low-Back Pain

Treatment for acute low-back pain is one of the most common reasons for outpatient physician visits and inconsistencies in how this symptom is treated is often blamed for waste in health care. In the October issue of the Journal of the American College of Radiology, radiologists at Emory University Hospital in Atlanta and Georgia Health Sciences University in Augusta, Ga., offer a solution. The radiologists developed a set of evidence-based guidelines suitable for inclusion in decision support systems that could assist physicians with managing patients with acute low back pain. The process starts at the initial visit, where patients are categorized into one of three groups after a thorough history and physical examination:

• non-specific low-back pain
• low-back pain potentially associated with radiculopathy or spinal stenosis
• low-back pain potentially associated with a specific cause

Evidence-based order sets are then provided for each category to guide the practitioners through the process of evaluation, management and follow-up of patients. Order set templates for use at the initial follow-up visit at four weeks provide evidence-based recommendations for appropriate imaging, laboratory workup, referral for invasive procedures or surgical consultation.