Oh my aching back! Too often at the first flinch of pain, you trot to the medicine cabinet and swallow a couple of Advil or Tylenol. Worst yet, you might take an opioid: Oxycodone or Fentanyl.
You should know before you begin the pill for pain ritual that the American College of Physicians (ACP) now has new guidelines recommending alternative therapies instead of pain meds for lower back pain.
The ACP (148,000 members) has finally admitted it: their chief tool to treat one of America’s most common aliments doesn’t work.
New ACP guidelines released this month suggested doctors recommend exercise and treatments like heat wraps, yoga, and mindfulness meditation to their patients before proscribing medications like over the counter painkillers or opioids.
You say you don’t have lower back pain? Congratulations! You’re the exception.
Low back pain is one of the top reasons people see their doctors and this nuisance aliment is the number one reason for missing work throughout the world.
Here’s the capper. Lower back pain is incredibly common-yet doctors don’t really know what causes it.
The kind of low back pain we are talking about has no detectable cause, unlike a tumor, pinched nerve or a fracture. It can be acute (last four weeks), sub acute (last four to six weeks) or chronic (12 or more weeks). Rarely, though, is it a sign of a more serious problem.
Doctors pencil it in as “nonspecific low back pain.”
There is no silver bullet but there are treatments that can reduce the pain. A major suggestion you should be doing anyway: exercising moderately without breaking your back (pun). Exercising, perhaps, is the best alternative to drugs.
It’s a given that obesity, smoking, depression and anxiety all have been linked with lower back pain. What’s the cure? Replacing prescription drugs in addition to exercise and heat therapy reveals a myriad of other suggestions:
Heat therapy is a good line of defense for acute or sub acute low back pain. This alternative strategy can be followed by massage, acupuncture, and spinal manipulation by a chiropractor may help.
For chronic back pain, exercise, rehabilitation therapy, acupuncture and mindfulness-based stress reduction can be utilized.
Other non-drug therapy can be tai chi, yoga, low-level laser therapy, cognitive behavioral therapy and spinal manipulation. It should be stressed that none of the previous suggestion therapies have been proven to be complete solutions for lower back pain.
Therefore, if these non-drug therapies do not provide relief, then the physician and patient consider treatment with NSAIDs as a first line therapy. Consider Tramadol or Duloxetine as second line therapy.
Physicians should consider opioids as a last option for treatment and only for patients who have failed other therapies. Opioids are associated with substantial harm including the risk of addiction or accidental overdose.
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