Sigillo Chiropractic Diagnosis and Treatment of Low Back Pain The American College of Physicians and the American Pain Society have issued a Joint Clinical Practice Guideline. The key recom mendation: "For patients who do not improve with self-care options, clinicians should consider the addition of nonpharmacological therapy with proven benefits -for acute low back pain, spinal manipulation: for chronic or subacute low back pain, intensive interdisciplinary rehabilitation, exercise therapy, acupunc- ture, massage therapy, spinal manipulation, yoga, cognitive-behavioral Dr. Christopher J. Sigillo, D.c. therapy, or progressive relaxation The research supporting this recommendation: Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline (Cho and Huffmann, Annals of Internal Medicine, 2007) found "Good evidence that cognitive-behavioral therapy, exercise, spinal ma- nipulation, and interdisciplinary rehabilitation are all moderately effective for chronic or subacute (longer than 4 weeks' duration) low back pain." Also cited was Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systemic review and best evidence synthesis (Spine Journal May-June 2004) "For acute low back pain (less than 4 weeks' duration), the only non- pharmacologic therapies with evidence of efficacy are superficial heat and spinal manipulation." Presented as a service to the community by Sigillo Chiropractic 18 Graves St., Brockport 637-3630. Most major insurance accepted. Visit us on the web at www.sigillochiropractic.com