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By Australian Acute Musculoskeletal Pain Guidelines Group.

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Additional info for Evidence-based management of acute musculoskeletal pain

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Currently they are not subsidised for acute musculoskeletal pain in Australia. 6 Management plan for acute musculoskeletal pain > Opioid Analgesics Opioid analgesics bind to opioid receptors both within and outside the central nervous system and are used for management of severe pain. All opioid medications have the potential to cause side effects including constipation, urinary retention, sedation, respiratory depression, nausea and vomiting. Titration of medication should occur to optimise the response to the analgesic and to minimise side effects.

Information and advice to patients with back pain can have a positive effect. Spine, 24: 2484–2491. Croft PR, Macfarlane GJ, Papageorgiou AC, Thomas E, Silman AJ (1998). Outcome of low back pain in general practice: a prospective study. British Medical Journal, 316: 1356–1359. Deyo RA, Diehl AK, Rosenthal M (1987). Reducing roentgenography use: can patient expectations be altered? Archives of Internal Medicine, 147: 141–145. Indahl A, Haldorsen EH, Holm S, Reikeras O, Ursin H (1998). Fiveyear follow-up study of a controlled clinical trial using light mobilization and an informative approach to low back pain.

LEVEL I, II: Based on systematic reviews (Nelemans et al. 2002; Watts and Silagy 1995; Koes et al. 1999) and an RCT (Garvey et al. 1989) Adverse effects of injection therapy are rare but serious. Lumbar Supports — There are no controlled studies on the effect of lumbar supports in acute low back pain. No Level I or II evidence There is insufficient evidence that lumbar supports are effective in reducing pain compared to spinal manipulation, exercises, massage, TENS and simple analgesia in mixed populations with low back pain.

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