Acute low back pain: a new paradigm for management

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Abstract
The new clinical guidelines issued by Britain's Royal College of General Practitioners highlight new principles of back pain management that have emerged in the past decade.1 The era of routine radiography, strict bed rest, corsets, and traction has passed. It has been replaced by parsimonious imaging, early return to normal activities, and greater emphasis on exercise to prevent recurrences or to treat chronic pain. Physical activity is guided by setting goals (even if there is some discomfort) rather than by the traditional dictum to “let pain be your guide.” These newer concepts are based on steadily improving scientific evidence, and represent a major shift from the earlier paradigm of rest and pain contingent treatment.