On Monday, the American College of Physicians released updated guidelines that urge doctors to avoid medication as the first-line therapy for lower back pain-a departure from its previous guidelines. There is also evidence for massage, acupuncture, and spinal manipulation. Opioids, skeletal muscle relaxants, and systemic corticosteroids, meanwhile, appear to provide only low-to-moderate relief and only for a limited amount of time.
Don't bother with acetaminophen - evidence suggests it isn't effective at improving pain compared to a placebo. "/ Annals of Internal Medicine".
Massive Problem in the US Low back pain is a very common reason for patients to see a doctor, and around one-quarter of US adults have reported the problem within the past three months.
"The chiropractic profession has long advocated for doctors and patients to use a more conservative approach to treating low back pain", said ACA President David A. Herd, DC.
The American College of Physicians released new guidelines detailing how to deal with back pain, which affects about one-fourth of all Americans at any given time, NBC News reports.
For pain that lasts for more than 12, weeks, exercise therapies such as acupuncture, yoga, tai chi, cognitive behavior therapy, mindfulness-based stress reduction, and guided relaxation techniques can still be effective, the guidelines said. ACP emphasizes that physical therapies should be administered by providers with appropriate training.
For those with chronic back pain who find non-drug therapy unsuccessful, physicians should suggest ibuprofen or naproxen and only look to opioids as a last-case scenario, according to the guidelines.
Opioids should only be considered as last resorts, and only prescribed after doctors discuss their risks and benefits with patients.
The author of an accompanying editorial notes that these recommendations are likely to be a major change for primary care physicians.
The health outcomes evaluated by the ACP include the reduction or complete elimination of low back pain, improvement in overall motor function and quality of life, reduction or elimination of work disability, and drug side effects.
The ACP have reached their conclusions through a meticulous reviewing process that consists of several stages: a systematic review of the evidence available; a deliberation based on the evidence; a summary of the recommendations; grading the quality of the evidence; and issuing the recommendations. Those with chronic pain-12 weeks or more-should also start with the same non-invasive remedies before seeking more serious treatments. "Pharmacological treatments are easy to prescribe, but they all carry varying risks of harm".