If you were about to head to the medicine cabinet to get some relief for your back pain, stop right there. The American College of Physicians is now recommending non-drug measures for treating certain kinds of pain.
In an evidence-based clinical practice guideline published on Feb. 14, the ACP says physicians and patients should first treat back pain with measures like yoga and massage.
“Low back pain is one of the most common reasons for physician visits in the United States,” the guideline reads. “Most Americans have experienced low back pain, and approximately one quarter of U.S. adults reported having low back pain lasting at least one day in the past three months.”
Back pain is categorized as acute (lasting less than four weeks), subacute (lasting four to 12 weeks) and chronic (lasting more than 12 weeks).
“Physicians should reassure their patients that acute and subacute low back pain usually improves over time regardless of treatment,” says Nitin S. Damle, MD, MS, MACP, president, ACP. “Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients.”
The study showed that acetaminophen was not effective at improving back pain when compared to a placebo and that systemic steroids were not effective in treating acute or subacute low back pain.
When it comes to chronic low back pain, the ACP recommends first selecting non-drug therapy. That includes “exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor control exercise (MCE), progressive relaxation, electromyography biofeedback, low level laser therapy, operant therapy, cognitive behavioral therapy or spinal manipulation.”
Damle says physicians should first select the therapies that have the fewest harms and costs. Of course, these therapies should be administered only by trained professionals.
“Physicians should consider opioids as a last option for treatment and only in patients who have failed other therapies, as they are associated with substantial harms, including the risk of addiction or accidental overdose,” Damle said.
A Consumer Reports survey recently showed many people with back pain found alternative therapies useful. The survey found that almost 90 percent of those who tried yoga or tai chi said they were helpful, while 84 percent and 83 percent, respectively, said the same of massage and chiropractic treatments.