As a chiropractor and an acupuncturist, I see a lot of people suffering from low back pain. Most patients come to me before visiting an MD. Far too often, though, I treat people with low back pain who want to stop taking physician prescribed pain medications. Even worse, many patients find me who have already endured invasive spine surgery and still experience back pain.
The American College of Physicians (ACP), the largest medical specialty organization in the United States, made a positive move toward reducing unnecessary surgeries and narcotic pain medication use. In February, 2017, the ACP released new guidelines for physicians that place conservative therapies such as acupuncture, spinal manipulation, and mediation at the top of the list for low back pain treatment.
Twenty-five percent of adults in the US experience low back pain. It is one of the most common reasons Americans visit the doctor. Medical professionals generally prescribe muscle relaxant or pain relieving medications. Now they are advised to prescribe conservative therapies such as acupuncture, chiropractic, massage, and meditation before potentially harmful pharmaceutical intervention.
Low back pain is categorized into three classifications according to how long it endures. Acute low back pain is pain that is experienced for less than four weeks. Subacute back pain has endured for four to twelve weeks. Low back pain is consider chronic if it has not resolved in twelve or more weeks.
The new ACP guidelines suggest that physicians make sure patients know that acute and subacute low back pain usually gets better over time regardless of treatment. Conservative therapies such as acupuncture, chiropractic, and heat therapy are advised. If pain relieving medications are indicated during the acute and subacute stages, non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants are strongest to be used.
When low back pain does not resolve within twelve weeks, physicians and patients should initially choose a non-drug multidisciplinary rehabilitation approach that includes exercise and therapies such as acupuncture, chiropractic, tai chi, yoga and meditation. NSAIDs are still the recommended first-line pharmaceutical intervention in chronic cases. Stronger non-opioid medications are recommended only if NSAIDs fail. Opioid drugs are now the third and last resort used only if the above therapies do not work.
Thank you to the ACP for the acknowledgment of non-invasive, patient-centered care and its importance in making us a healthier nation.
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