What are the Philadelphia Panel treatment guidelines for mechanical low back pain?

Updated: Mar 06, 2018
  • Author: Everett C Hills, MD, MS; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

The Philadelphia Panel evaluated the literature on the treatment of LBP and assigned Grades of Recommendation based on the clinical importance of the studies, statistical significance of the findings, and the study design. [3] Randomized control trials with statistically significant findings were assigned an A grade. Any study design without clinically significant findings but thought to have been worth performing was assigned a D grade. Grades of Evidence were assigned to the various studies. The highest grades were I for randomized control trials and III for the opinions of respected authorities.

  • For LBP of less than 4 weeks duration, the Philadelphia Panel found poor evidence (grade C) to include or exclude therapeutic exercises, traction, ultrasonography, or TENS. Return to work was strongly encouraged.

  • For LBP of 4-12 weeks duration, the Philadelphia Panel found good evidence for the inclusion of therapeutic exercise and manual traction.

  • For LBP of greater than 12 weeks' duration, the Philadelphia Panel found good evidence for the inclusion of therapeutic exercises, therapeutic ultrasonography, and electromyographic biofeedback. These treatments were positive interventions for achieving adequate pain control, increasing functional activities of daily living, and promoting return to work.


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