Guidelines, recommendations for management of acute low back pain in adults

Low back pain is one of the most common complaints expressed by patients in the primary care setting. In the past decade, multiple guidelines and recommendations have been published to help health care providers identify when imaging for patients with low back pain is appropriate during the first six weeks of treatment.

Patients sometimes will complain of low back pain along with symptoms such as unexplained weight loss, sudden bowel or bladder dysfunction, acute dysesthesia or weakness of the legs. These are red flags for more serious conditions and imaging within the first six weeks may be necessary.

However, most patients with low back pain don’t have these red flag symptoms and imaging in the first six weeks of treatment isn’t recommended. The risks to patients receiving routine imaging not only include increased radiation exposure but also a decrease in the patient’s sense of well-being. Studies have shown patients who had an early MRI were 2 to 8 times more likely to undergo surgery.

MQIC guideline updated
For additional guidance, review the Michigan Quality Improvement Consortium’s Management of Acute Low Back Pain in Adults,** which has been updated for 2020.

Also, Choosing Wisely^®,** an initiative of the American Board of Internal Medicine Foundation, offers recommendations on when to use imaging for low back pain here.**

**Blue Cross Blue Shield of Michigan doesn’t own or control this website.