Designed and created by Guideline Central in participation with the Veterans Health Administration / Department of Defense
Diagnosis and Treatment of Low Back Pain (LBP)
Last updated March 3, 2023
This patient summary means to discuss key recommendations from the Department of Veterans Affairs, the Department of Defense, for low back pain. This patient summary is limited to adults 18 years of age and older and should not be used as a reference for children.
- Low back pain is a common medical condition causing pain and limiting function.
- We will use the abbreviation VA throughout this summary to refer to the Veterans Administration.
- Some of the most common causes of low back pain are overuse, misuse and trauma.
- Spinal joint and bone diseases and neurological (nerve) conditions can also cause low back pain.
- Pain may be confined to the low back or radiate into a leg.
- This patient summary focuses on proven effective treatments for low back pain.
- Your complete medical condition will be evaluated to pinpoint the cause of your pain.
- Imaging studies may be done.
- General education about pain management frequently helps reduce pain and improve function. This can include:
- Cognitive behavioral therapy
- Exercise programs individually tailored for you
- Spinal mobilization/manipulation may help.
- The VA has insufficient evidence to recommend many other treatments.
- Pain medications:
- duloxetine for chronic pain
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- opioids (morphine-like drugs) only if you are already using them
- The VA finds the evidence insufficient for other pain medications
- radiofrequency ablation of pain nerves
- The VA finds the evidence insufficient for other pain procedures
- The VA suggests a coordinated, multidisciplinary program including psychological, social and/or occupational components.
- LBP: Low Back Pain
- NSAIDs: Non-Steroidal Anti-Inflammatory Drugs
- VA: Veterans Administration
Pangarkar SS, Kang DG, Sandbrink F, Bevevino A, Tillisch K, Konitzer L, Sall J. VA/DoD Clinical Practice Guideline: Diagnosis and Treatment of Low Back Pain. J Gen Intern Med. 2019 Nov;34(11):2620-2629. doi: 10.1007/s11606-019-05086-4. Epub 2019 Sep 16. PMID: 31529375; PMCID: PMC6848394.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.