Low Back Disorders Chapter Released

American College of Occupational and Environmental Medicine (ACOEM) has released an extensive update to its evidence-based practice guidelines.

The chapter on low back disorders is the latest revision to ACOEM's Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery in Workers, 2nd Ed., currently in wide-spread use across the country.

Subscribers to UMK Professional (Utilization Management Knowledgebase), or the ACOEM Guidelines Electronic Version, have immediate access to the low back chapter free of charge.

The revised low back chapter contains the following enhancements:

-- Inclusion of numerous disorders including acute, subacute, and chronic low back pain, radicular pain syndromes, spinal stenosis, spinal fractures, sacroilitis, and spondylolisthesis.

-- Detailed recommendations regarding the use of appliances (e.g., lumbar supports, magnets), skilled non-medical therapies (e.g., massage, manipulation), ultrasound, low level laser therapy, electrical therapies (e.g., TENS, PENS), and acupuncture.

-- An in-depth review of medications and injection therapies to treat low back disorders.

-- A thorough review of surgical procedures on the low back including discectomy, spinal fusion, disc replacement, and implantable spinal cord stimulators.

-- Tables which summarize the recommendations by clinical measure and by low back disorder.

A crucial part of the updating process was ACOEM's adoption of a new more meticulous strength-of-evidence rating methodology which incorporates the highest scientific standards for reviewing evidence-based literature. As a result, the updated low back chapter contains an even more extensive list of references -- nearly 2,000 compared to the 150 plus in the previous version.