Management of patients with persistent and disabling back pain despite use of recommended therapies remains a challenge. A number of injections, other interventional therapies, and surgeries were not addressed in the previ- ous APS/ACP guideline, but are also available for treat- ment of back pain. In general, these therapies are consid- ered to be more invasive and attempt to target specific back structures or spinal abnormalities thought to be the source of back pain, such as back muscles or soft tissues, degenerated facet or sacroiliac joints, spinal canal steno- sis, and degenerated or herniated intervertebral discs. Several invasive diagnostic tests are also available. The purpose of such tests is to evaluate potential anatomic sources
