Low back pain is one of the most common reasons for all physician visits in the U.S. Most Americans have experienced low back pain. Approximately 1/4 of U.S. adults reported having low back pain lasting at least one day in the past three months.
The American College of Physicians (ACP) examines an evidence-based clinical practice guideline published today in Annals of Internal Medicine that physicians and patients should treat acute or subacute low back pain with non-drug therapies such as superficial heat, massage, acupuncture, or chiropractic (spinal manipulation).
“For the treatment of chronic low back pain, physicians should select therapies that have the fewest harms and costs, since there were no clear comparative advantages for most treatments compared to one another,” Dr. Damle MD. said. “Physicians should remind their patients that any of the recommended physical therapies should be administered by providers with appropriate training.”
“Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain” is based on a systematic review of randomized controlled trials and systematic reviews published on noninvasive pharmacological and non-pharmacological treatments of nonradicular low back pain. Clinical outcomes evaluated included reduction or elimination of low back pain, improvement in back-specific and overall function, improvement in health-related quality of life, reduction in work disability/return to work, global improvement, number of back pain episodes or time between episodes, patient satisfaction, and adverse effects.
“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,” said Dr. Damle MD.
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The American College of Physicians is the largest medical specialty organization in the United States. ACP’s clinical practice guidelines are developed through a rigorous process based on an extensive review of the highest quality evidence available, including randomized control trials and data from observational studies.