Recommendations

Document Overview

Design and created by Guideline Central in participation with the American College of Physicians.

Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain

American College of Physicians

Publication Date: Apr 1, 2017

Page Last Updated: May 5, 2026

American Academy of Family Physicians Grading System

American Academy of Family Physicians Grading System^a
Recommendation^b		Definition	Quality of Evidence^c
S	Strong	High confidence in the net benefit for patient-oriented outcomes. Most informed patients would choose recommended option.	H	High
S	Strong		M	Moderate
W	Weak	Lower confidence in the net benefit for patient-oriented outcomes. Patient choices may vary based on values and preferences.	M	Moderate
W	Weak		L	Low
GP		Good practice point

^a The AAFP uses a modified version of the Grading of Recommendations Assessment, Development and Evaluation (GRADE). [http://clinicalevidence.bmj.com/x/set/static/ebm/learn/665072.html ]
^b Recommendations can be either for or against an intervention or testing modality.
^c The strength of the recommendation should be consistent with the quality of the evidence such that strong recommendations are based on high-quality evidence, whereas weak recommendations are based on low- to moderate-quality evidence. Very low-quality evidence should be considered insufficient for a recommendation unless there are highly unusual circumstances and the benefits would greatly outweigh the harms.

Document Overview

Document Title: Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain

Authoring Society: American College of Physicians

Document Publication Date: Apr 1, 2017

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: annals.org/aim/fullarticle/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice

Source Citation: https://doi.org/10.7326/M16-2367

Supplemental Implementation Resources

Patient Information

Document Scope, Criteria, and Use Cases

Document Objectives: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on noninvasive treatment of low back pain.

Scope: Assessment and Screening, Management, Treatment

Diseases/Conditions (MeSH)

D059350 - Chronic Pain

D059408 - Pain Management

D001416 - Back Pain

D010146 - Pain

D059787 - Acute Pain

D017116 - Low Back Pain

Keywords: chronic low back pain, low back pain, low back pain (LBP), nonsteroidal anti-inflammatory drugs (NSAIDs)

Target Patient Population: Patients with low back pain

Inclusion Criteria: Male, Female, Adolescent, Adult, Older Adult

Health Care Settings: Ambulatory, Long Term Care, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resources: Systematic Review Document Systematic Review Document

Number of Source Documents: 184

Literature Search Start Date: Tuesday, January 1, 2008

Literature Search End Date: Tuesday, November 1, 2016

Includes peer/external review process?: Yes

Includes public comment process?: Yes

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes