• Mixed pain relief and functional improvement after 5 to 10 sessions of spinal manipulation over 2 to 4 weeks
  • NSAIDs or skeletal muscle relaxants – first line, use should be limited to 4 weeks after acute onset
  • most patients with acute or subacute low back pain improve over time regardless of treatment
  • Greater likelihood for a positive response from ESI after a herniated lumbar disk compared to axial (nonradicular) spine pain or spinal stenosis

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