New Guidelines Recommend Alternative Therapies for Back Pain

We often think of stress as a mental or emotional struggle, but stress can manifest itself in a number of ways. Chronic stress interferes with nearly every system in the body and is known to cause digestive symptoms, decreased energy levels, headaches, body aches, and muscle tension. April is Stress Awareness Month, which serves as a helpful reminder for everyone to evaluate areas of stress in their lives and understand how it affects them physically.

Back pain is one of the most common medical complaints among American adults, and it is sometimes linked to muscle tension from stress. Medication has long been considered a convenient and simple way to address back pain, but new guidelines released by the American College of Physicians (ACP) could change that. Departing from their previous recommendations, the organization now recommends that patients use alternative therapies such as yoga, massage or exercise before turning to medication.

The updated guidelines come as a result of analyzing over 150 studies to determine which treatments are successful in relieving back pain and which ones are not. Evidence showed that acetaminophen and steroid injections – two common treatments for back pain – were not effective in improving pain outcomes.

Patients with lower back pain may benefit from a variety of treatments including exercise, acupuncture, tai chi, yoga, progressive relaxation, or spinal manipulation. However, ACP President Dr. Nitin S. Damle says that most acute and subacute low back pain usually resolves on its own regardless of treatment. “Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients,” he says.

While Damle stresses that non-pharmacological treatments should be considered first, the guidelines do recommend nonsteroidal anti-inflammatory drugs or skeletal muscle relaxants for patients who desire medications.

The guidelines also recommend opioids only be prescribed as a last resort treatment. Due to the high risk of addiction and accidental overdose, these medications should only be given when all other therapies have failed.

The complete clinical practice guidelines are published in the Annals of Internal Medicine (Source: American College of Physicians).

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