, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved the joint Clinical Practice Guideline (CPG) for Diagnosis and Management of Low Back Pain. This CPG was intended to provide healthcare providers a framework by which to evaluate, treat, and manage patients with low back pain (LBP). METHODS: The VA/DoD Evidence-Based Practice Work Group convened a joint VA/DoD guideline development effort that included a multidisciplinary panel of practicing clinician stakeholders and conformed to the Institute of Medicine's tenets for trustworthy clinical practice guidelines. The guideline panel developed key questions in collaboration with the ECRI Institute, which systematically searched and evaluated the literature through September 2016, developed an algorithm, and rated recommendations by using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. A patient focus group was also convened to ensure patient values and perspectives were considered when formulating preferences and shared decision making in the guideline. RECOMMENDATIONS: The VA/DOD LBP CPG provides evidence-based recommendations for the diagnostic approach, education and self-care, non-pharmacologic and non-invasive therapy, pharmacologic therapy, dietary supplements, non-surgical invasive therapy, and team approach to treatment of low back pain.

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Meralgia paresthetica is a disorder of the lateral femoral cutaneous nerve that results in symptoms of anterolateral thigh paresthesias and dysesthesias without associated loss of reflexes or motor weakness. Chronic meralgia paresthetica, not related to traumatic or lesion-producing compression of the nerve, is associated with obesity, pregnancy, tight-fitting garments, as well as specific duty uniform belts used by police officers and carpenters. Cases are presented in which two U.S. soldiers in Iraq experienced symptoms of meralgia paresthetica, most likely due to repetitive wear of protective body armor. Although use of protective body armor is proven to be lifesaving, modifications to improve current equipment may help to decrease morbidities such as meralgia paresthetica.

Introduction Physical therapy (PT) is a high-volume service that treats musculoskeletal injury and improves return-to-duty rates. Our experience suggests that no-show (NS) and patient cancellation (PC) rates increase the further appointment that is booked in the future, impede access to care, and increase the healthcare delivery costs. The article’s purpose is to examine PT National Capitol Region (NCR) appointment data to inform appointment policies. Methods We utilized one year of retrospective Military Health System Management and Reporting Tool and Composite Health Care System Ad Hoc Data Pulls to review NCR PT appointment data to evaluate the effect of timing on NS and PC rates. Results We analyzed 797 new appointments at Walter Reed National Military Medical Center. Data revealed that 16% of patients seen within 10 days NS or PC; 22% of patients seen between 11 and 20 days NS or PC; 28% of patients seen 21 to 30 days NS or PC; and 25% of patients seen over 30 days after consultation NS or PC. We analyzed 182,134 PT appointments (all types) in the NCR. The NS rate was 11.1% (range 8.4–14.9%). Conclusions At Walter Reed National Military Medical Center, 17% of new appointments were lost when they were booked over 20 days in advance; additionally, NS and PC rates were greatest after 20 days from consultation.