The American College of Physicians now lists Acupuncture as their top choice for both acute and chronic back pain! We were excited to see all of the media coverage of the latest recommendations on the treatment of Pain. The story has been featured on ABC, NBC, Fox News, and CBS. The American College of Physicians recommendations has also been reported on in most major newspapers. Here are some excerpts from this week’s Wall Street Journal article explaining the new recommendations for the treatment of Back Pain.
New guidelines from the American College of Physicians say that low back pain is best treated with alternative therapies. About 80% of adults experience low back pain at some point in their lifetimes. Back Pain is the most common cause of job-related disability and a leading contributor to missed work days.
The new guidelines are an update from 2007, and include a review of more than 150 studies. Recommendations were broken down into acute lower back pain, which is pain lasting less than 12 weeks, and chronic pain, which is pain lasting more than 12 weeks.
For acute pain, the guidelines recommend nondrug therapies first, such as applying heat, massage, acupuncture or spinal manipulation, which is often done by a chiropractor.
For chronic back pain, the guidelines recommend patients also first try non-drug therapies, such as acupuncture, exercise, rehabilitation therapy and mindfulness-based stress reduction.
The guidelines were designed to reduce pain and improve function If non-drug treatments fail to provide relief, the ACP says that NSAIDS should be the first medicine that is used. The third line of treatment should be duloxetine—sold under the brand name Cymbalta and commonly used to treat depression and anxiety—or tramadol, an opioid-like narcotic which is less potent than standard opioids such as oxycodone or fentanyl—but can still cause physical dependence.
Opioids—one of the most commonly prescribed medications for pain relief and a source of increasing addiction and death—should only be considered for chronic back pain when other alternatives—natural and prescription—don’t work, say the guidelines published in the Annals of Internal Medicine. The new guidelines warn that opioids should only be considered an option if the doctor and patient have a discussion about the known risks of the drugs, and if used at the lowest possible dose for the shortest period. Experts believe that opioid prescriptions for pain is a common gateway to opioid addiction. Opiods are also seen as a gateway to heroin, said Steven Atlas, director of practice-based research at Massachusetts General Hospital.
Even acetaminophen, which includes the brand name Tylenol, is no longer recommended for acute lower back pain relief due to a 2014 study in the journal The Lancet that showed it was no more effective than placebo.
Pain can begin abruptly as a result of an accident or by lifting something heavy. More often, though, it develops over time due to age-related changes of the spine and disc degeneration. Most back pain occurs between ages 30 and 50. Individuals who gain weight and don’t exercise have increased risk, as are those who exercise intensely after long periods of not exercising.