Last April, I told you all about the guidelines for prescribing opioids for chronic pain that the Centers for Disease Control and Prevention (CDC) released. These guidelines were created to help battle the opioid epidemic in the United Sates. Now, the American College of Physicians (ACP) is joining the fight against opioids by releasing new guidelines for treating lower back pain.
The reason for releasing these guidelines is to “present the evidence and provide clinical recommendations on noninvasive treatment of lower back pain”. The ACP wants physicians to use non-pharmacological treatment methods first. An opioid addiction can often begin with a prescription for treating lower back pain.
Lower back pain is one the most common reasons American adults will visit a doctor. According to the ACP, nearly 25 percent of U.S. adults have reported having lower back pain that lasted at least one day in the past three months. Many times after a doctor’s visit for lower back pain, a doctor will prescribe medication as the first step in treatment. The ACP is seeking to change this.
Is Lower Back Pain the New Common Cold
A major reason why treating lower back pain should focus on non-pharmacological methods is because back pain tends to run a natural course. For most people with acute back pain (lasting four weeks or less that does not radiate down the leg), there is absolutely no need to see a doctor. Much like a cold, it is common and bothersome but typically will not result in anything serious.
Even when it comes to chronic lower back pain, many patients can find better relief from physical or occupational therapy, exercise, or yoga, than with opioid treatment. Though some cases of chronic lower back pain will not be able to be managed with non-pharmacological methods, drug treatment should not be the first line of therapy.
New Guidelines for Treating Lower Back Pain
The ACP wants their guidelines to be share not only with physicians and physical or occupational therapists, but also with adults that are suffering from acute, sub acute, or chronic lower back pain.
Here are the new guidelines for treating lower back pain so you can share them with your patients on your next travel therapist assignment:
Lower Back Pain Guideline 1
When treating acute or subacute lower back pain, clinicians should choose non-pharmacologic treatments with the use of superficial heat as first-line therapy. This can include massage therapy, acupuncture, or spinal manipulation. If medication is desired, steroid injections and acetaminophen should not be prescribed. Instead, drugs like aspirin, ibuprofen, and naproxen may be used to provide relief.
Lower Back Pain Guideline 2
When treating chronic lower back pain, physicians should initially look for non-pharmacologic treatments that may include acupuncture, tai chi, yoga, cognitive behavioral therapy, and mindfulness-based stress reduction.
Lower Back Pain Guideline 3
In patients with chronic lower back pain that have not shown a sufficient response to non-drug-related treatment methods may consider non-steroidal injections as the first line of therapy. Opioids should only be prescribed if the patient has failed previous non-pharmacological treatment attempts, and the potential benefits outweigh the risks of opioid use for the patient.