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Effective Health Care Program

Noninvasive Treatments for Low Back Pain: Current State of the Evidence


This CME activity is hosted on the Baylor College of Medicine CME Web site (

Course Overview

Low back pain is one of the most frequently encountered conditions in clinical practice. Up to 84 percent of adults have low back pain at some time in their lives, and over one quarter of U.S. adults report recent (in the last 3 months) low back pain. Low back pain has high direct and indirect costs and is a common reason for missed work.

The prognosis for acute nonradicular low back pain is generally favorable. Studies have shown that improvements in pain (mean reduction to 58% of initial pain scores) occurred in 1 month. In patients with persistent symptoms, continued improvement is often seen in the subacute phase between 4 and 12 weeks. In a minority of patients, nonradicular low back pain lasts longer than 12 weeks, at which point it is considered chronic. Patients with chronic back pain account for the bulk of the burden and cost of low back pain. Predictors of chronicity are related to various psychosocial factors, the presence of nonorganic signs or symptoms, high baseline functional impairment, and low general health status.

Multiple treatment options for acute and chronic low back pain are available. This systematic review aimed to assess the benefits and harms of different pharmacological and noninvasive nonpharmacological therapies for adults with acute, subacute, or chronic nonradicular or radicular low back pain.

Educational Objectives

At the conclusion of this activity, the participant should be able to:

  • Describe the evidence regarding the effectiveness and harms of noninvasive treatments for nonradicular acute and chronic low back pain.
  • Describe the evidence regarding the effectiveness and harms of noninvasive treatments for radicular low back pain.
  • Describe the gaps in the current evidence base and areas needing additional research regarding noninvasive treatments for low back pain.

Target Audience

This CME activity is designed to meet the educational needs of primary care physicians, family physicians, orthopedic surgeons, rehabilitation medicine specialists, pain specialists, physical therapists, physician assistants, nurse practitioners, and other health care professionals who treat adults with low back pain.

Method of Participation

This activity is in PDF and HTML formats and is accompanied by references linked to PubMed abstracts.

To receive a maximum of 0.50 AMA PRA Category 1 Credit(s)™ you should:

  • View the presentations in this enduring material.
  • Complete the posttest (you must answer 4 out of 5 questions correctly).
  • Complete and submit the CME registration and evaluation forms.

The estimated time to complete this activity, including review of the materials, is 0.50 hour(s).

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 0.50  AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Term of Approval

November 2016 through November 2018. Original release date: November 2016 

Acknowledgement of Support

This CME activity is supported by an educational grant from This CME activity is supported by a contract, HHSA290201410015C, from the Agency for Healthcare Research and Quality.