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Objective: This abbreviated version of the American College of Occupational and Environmental Medicine's Low Back Disorders guideline reviews the evidence and recommendations developed for invasive treatments used to manage low back disorders., Methods: Comprehensive systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking and often relied on analogy to other disorders for which evidence exists. A total of 47 high-quality and 321 moderate-quality trials were identified for invasive management of low back disorders., Results: Guidance has been developed for the invasive management of acute, subacute, and chronic low back disorders and rehabilitation. This includes 49 specific recommendations., Conclusion: Quality evidence should guide invasive treatment for all phases of managing low back disorders., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 American College of Occupational and Environmental Medicine.)

Objective: This abbreviated version of the American College of Occupational and Environmental Medicine's (ACOEM) Low Back Disorders Guideline reviews the evidence and recommendations developed for non-invasive and minimally invasive management of low back disorders., Methods: Systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking. A total of 70 high-quality and 564 moderate-quality trials were identified for non-invasive low back disorders. Detailed algorithms were developed., Results: Guidance has been developed for the management of acute, subacute, and chronic low back disorders and rehabilitation. This includes 121 specific recommendations., Conclusion: Quality evidence should guide treatment for all phases of managing low back disorders.

Objective: The aim of this study was to summarize evidence-based diagnostic guidelines for low back disorders., Methods: A comprehensive literature review was conducted. A total of 101 articles of high or moderate quality addressing low back disorders diagnostic evaluation met the inclusion criteria. Evidence-based recommendations were developed and graded from (A) to (C) in favor and against the specific diagnostic test, with (A) level having the highest quality body of literature. Expert consensus was employed for insufficient evidence (I) to develop consensus guidance., Results: Recommendations are given for these diagnostic tests: functional capacity evaluations, roentgenograms (x-rays), magnetic resonance imaging (MRI), computerized tomography, myelography, bone scans, single proton emission computed tomography, electromyography, surface electromyography, ultrasound, thermography, fluoroscopy, videofluoroscopy, lumbar discography, MRI discography, and myeloscopy., Conclusion: Diagnostic testing is not indicated for the majority of patients with low back pain.

A questionnaire survey was carried out in one practice to determine the relationship between sexual abuse in childhood and subsequent psychological morbidity. Out of 418 women who replied (62% response rate), 60 (14%) admitted experiencing some form of sexual abuse as a child. Twenty of these (33%) were found to have a record of some form of psychological problem in adult life, compared with 14% of a sample of the non-abused respondents and 20% of the non-respondents. In particular, 54% of 13 women who had experienced oral, genital or anal penetration or attempted penetration had psychological morbidity recorded. There was no relationship, however, between sexual abuse and psychosexual or marital problems in later life.