The new guidelines include three primary recommendations for people with lower back pain. In a simplified version, here is what they suggest:
- In people with acute or sub-acute lower back pain, patients should select non-pharmacological treatment with superficial heat, massage, acupuncture or spinal manipulation (This is a chiropractic adjustment). If pharmacological treatment is desired, clinicians and patients should select non-steroidal anti-inflammatory drugs or skeletal muscle relaxants.
- For people with chronic lower back pain, patients should initially select non-pharmacological treatment with exercise, rehabilitation, acupuncture, spinal manipulation (chiropractic adjustments) and mindfulness-based stress reduction such as tai chi, yoga, motor control exercise etc.
- In people with chronic lower back pain that have not responded to the non-pharmacological therapy, they should then consider pharmacological treatment with non-steroidal anti-inflammatory drugs as first-line therapy.
Interestingly, Dr Mercola said that steroid injections and acetaminophen (Aspirin) are discouraged, as studies suggest neither is helpful or beneficial. Acetaminophen does not lower inflammation, and a review of the research shows steroids are on par with placebo when it comes to treating back pain in the long term.
What to make of this
I think these guidelines are great and back up the way I have been practicing for a while. I also think medications should be used as a last resort. Don’t get me wrong, sometimes they are needed, but ideally they should only be used after you have tried the other options. It is great to see that organisations like The American College of Physicians are finally taking this approach. If you do take medication, be aware that they tend to hide problems rather than fix them, so you still need to ‘baby’ the back for a while if you are taking medication.
In people with chronic problems, again therapies like chiropractic care can be helpful, but they will work best in conjunction with appropriate rehab exercises, improving movement patterns and stress reduction. These are things that I like to focus on at Elevate Chiropractic. I like to prescribe appropriate exercises and stretches and helping change movement patterns that may be slowing the healing process. If you don’t find out what's causing the issue, especially in a chronic problem, then there is a likelihood that it will persist.
If you have a problem, whether it be acute or chronic, and would like it assessed, please call the clinic to arrange a time for an assessment. In the meantime read my previous blog post here on some simple ways to help with lower back pain at home. Your body will thank you for it.
- Image: http://www.medscape.com/viewarticle/849851