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Recomendación 1:

Se define lumbalgia como dolor o malestar localizado entre el borde inferior de las últimas costillas y el pliegue inferior glúteo, con o sin irradiación a una o ambas extremidades inferiores, sin que ésta deba ser considerada de origen radicular.

Según el tiempo de duración del dolor, la lumbalgia se clasifica en:

• Aguda: dolor de menos de 6 semanas.
• Subaguda: dolor de 6-12
• Crónica: más de 12 semanas con

Recurrente: lumbalgia aguda en paciente que ha tenido episodios previos de dolor lumbar en una localización similar, con períodos libres de síntomas de tres meses. (Recomendación condicional a favor)

Recomendación 2:
Los signos de alarma en la lumbalgia son: edad mayor a 50 años, antecedentes de neoplasia, síndrome consuntivo sin mejoría con tratamientos habituales, dolor en reposo, fiebre, inmunosupresión, traumatismo previo, osteoporosis, toma de corticoides y síndrome de cauda equina. (Recomendación condicional a favor)

Recomendación 3:
No se sugiere la realización de pruebas de laboratorio o imagen (radiografía, tomografía, resonancia) en pacientes con dolor lumbar agudo o subagudo sin signos de alarma. (Recomendación condicional en contra)

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Recomendación 1:
No se sugiere reposo en cama en pacientes con dolor lumbar agudo o subagudo. (Recomendación condicional en contra)

Recomendación 2:
Se sugiere en pacientes con dolor lumbar agudo o subagudo continuar con la actividad física y mantener las actividades de la vida diaria, incluyendo la actividad laboral, tanto como sea posible. (Recomendación condicional a favor)

Recomendación 3:
No se sugiere implementar programas de escuela de espalda para pacientes con lumbalgia aguda y subaguda. (Recomendación condicional en contra)

Recomendación 4:
Recomendamos la terapia manual de manipulación y movilización de tejidos blandos brindada por un médico rehabilitador o terapista físico en un servicio de rehabilitación para el manejo de lumbalgia aguda y subaguda, de acuerdo a disponibilidad del servicio. (Recomendación fuerte a favor)

Recomendación 5:
No se sugiere usar los soportes lumbares (fajas o corsés) para el manejo de lumbalgia aguda y subaguda.(Recomendación condicional en contra)

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Recomendación 1:
No recomendamos la utilización de paracetamol – independientemente de la dosis – como monoterapia de primera elección en el tratamiento de la lumbalgia aguda y subaguda. (Recomendación fuerte en contra)

Recomendación 2:
Se sugiere AINEs como tratamiento de primera línea de la lumbalgia aguda y subaguda. (Recomendación condicional a favor)

Recomendación 3:
Se sugiere agregar un relajante muscular si el dolor lumbar agudo y subagudo persiste tras iniciar el tratamiento con AINE. (Recomendación condicional a favor)

Recomendación 4:
Se sugiere el uso de un opiáceo débil (tramadol, codeína) si la lumbalgia aguda y subaguda persiste tras iniciar el tratamiento con AINE y relajante muscular. (Recomendación condicional a favor)

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