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Opioid treatment for chronic low back pain increases the risk for lifetime illicit drug use [100] and the effect of long-term use of opioids for lower back pain is unknown. [101] For older people with chronic pain, opioids may be used in those for whom NSAIDs present too great a risk, including those with diabetes, stomach or heart problems.
"Pain ladder", or analgesic ladder, was created by the World Health Organization (WHO) as a guideline for the use of drugs in the management of pain. Originally published in 1986 for the management of cancer pain , it is now widely used by medical professionals for the management of all types of pain .
In 2007, the American College of Physicians and the American Pain Society jointly recommended that clinicians consider spinal manipulation for patients who do not improve with self-care options. [6] Reviews published in 2008 and 2006 suggested that SM for low back pain was equally effective as other commonly used interventions.
Williams, Paul C. (1974), Low Back and Neck Pain: Causes and Conservative Treatment, Ed 3; Springfield:Charles C Thomas; 78 pages. Williams P, (1955), "Examination and conservative treatment for disc lesions of the lower spine", Clinical Orthopaedics and Related Research 528-40.
Back pain is extremely common — most people will experience it at some point in their lives, and lower back pain is the leading cause of disability worldwide.
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