New Acute Low Back Pain Guideline and Systematic Review
New Acute Low Back Pain Guideline and Systematic Review Now Available
The American Academy of Pain Medicine (AAPM) has launched a new evidence-based Assessment and Treatment of Acute Low Back Pain: A Multidisciplinary Clinical Practice Guideline, together with its companion systematic review, clinician implementation tools, patient resources, and free 1.5 CME education.
Designed for clinicians caring for adults with atraumatic acute low back pain lasting less than six weeks, with or without radiculopathy, the guideline provides practical recommendations for outpatient care. Developed through systematic review and multidisciplinary expert input, the guideline uses the GRADE framework to support evidence-based, individualized clinical decision-making.
Explore the Acute Low Back Pain Guideline and Systematic Review
Evidence to Support Practical, Patient-Centered Care
Acute low back pain is common, and the first clinical encounter can play an important role in establishing expectations and helping patients understand their options. The new guideline emphasizes a stepwise approach that begins with lower-risk interventions, patient education, and shared decision-making.
For most patients with uncomplicated acute low back pain, the guideline recommends against routine early imaging and encourages education, continued low-impact activity, and appropriate self-management. When symptoms remain unchanged or worsen, clinicians may consider additional evidence-based pharmacologic and nonpharmacologic options based on the patient's health status, preferences, response to treatment, access, safety, and cost. Opioids should not routinely be used as initial treatment. American Academy of Pain Medicine
The companion systematic review provides the evidence foundation for these recommendations. Its evidence base included 105 studies reported in 111 publications addressing assessment, imaging, pharmacologic and nonpharmacologic treatment, physical therapy, and other aspects of acute low back pain management.
Resources for Clinicians
AAPM's dedicated Clinician Resources page translates the guideline into tools that can support everyday practice. Clinicians can review key recommendations, access the full guideline and systematic review, and use practical materials developed to reinforce consistent, evidence-based conversations with patients.
Explore Acute Low Back Pain Resources for Clinicians
Earn 1.5 CME Credits - FREE
To help clinicians put the recommendations into practice, AAPM is offering a free 1.5-hour on-demand
CME program.
The case-informed program focuses on real-world application, including how to explain why an MRI may not be needed, structure a stepwise management approach, discuss nonopioid and nonpharmacologic options, and determine when escalation may be appropriate.
Resources Patients Can Use
Evidence-based care also depends on giving patients clear information they can understand and use. AAPM's Acute Low Back Pain Patient Resources page provides guideline-aligned tools to help patients understand acute low back pain, recognize when they should seek care, prepare for conversations with their healthcare professional, and participate in shared decision-making.
Patient materials reinforce that most acute low back pain improves over time, routine early MRI is often unnecessary, gentle movement can support recovery, and opioids are generally not the first choice for treatment. The resources also help patients identify symptoms that may require more immediate medical attention.
Access the Patient ALBP Resources
With Appreciation
AAPM gratefully acknowledges guideline authors Andrea C. Skelly, PhD, MPH; Devan Kansagara, MD; Jessica Oswald, MD; and Roger Chou, MD, along with the multidisciplinary Guideline Development Group and AAPM consultants. Visit the guideline page for the full list of contributors.
We also thank systematic review authors Andrea C. Skelly, Roger Chou, Erika D. Brodt, Ian Blazina, Esther K. Choo, Tracy Dana, Andrea Diulio-Nakamura, Rongwei F. Fu, Yun Yu, Nancy A. Carney, Annette Totten, Kim Mauer, Dakota Riopelle, and Shay Stabler-Morris for the rigorous evidence synthesis that informed this work.
Funding and attribution: This project is supported by the Food and Drug Administration (FDA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award (FAIN) totaling $1,999,980, with 100 percent funded by FDA/HHS. The content is that of the author(s) and does not necessarily represent the official views of, nor any endorsement by, FDA/HHS or the U.S. Government. Oregon Health & Science University Evidence-based Practice Center, Aggregate Analytics, and the American Academy of Pain Medicine. Assessment and Treatment of Acute Low Back Pain, 2026.