Have back pain? You are not alone. Most of us have experienced back pain at one time or another. Not surprisingly, it’s one of the most common issues that send scores of people to see the doctor every year. But if you’re primed for walking out of the clinic with a prescription, you might be in for a little surprise.
The Dope on Drugs
Think you need over-the-counter or prescription drugs to treat low back pain? Not so, says the American College of Physicians (ACP). On February 14, the largest physician group in the U.S. released updated guidelines recommending people should treat low back pain with non-drug therapies instead.
Why, you asked? Well, as it turns out, that “trusty” bottle of acetaminophen (e.g. Tylenol®) you’ve been reaching for all these years simply doesn’t work for low back pain. The ACP also takes a stance against doctors prescribing opioid painkillers due to the serious addiction and overdose risks associated with them. Steroid injections, corticosteroid pills, and antidepressants also get a thumb down when it comes to treating low back pain.
Non-steroidal anti-inflammatory drugs (NSAIDs), including non-prescription meds like ibuprofen (e.g. Advil®, Motrin®), may be helpful as a secondary approach (after non-drug methods) for acute and subacute back pain (up to 12 weeks), but they are not recommended as the starting point. For chronic back pain, the guidelines also advocate only selecting NSAIDs if the non-drug approaches are insufficient, “and only if the potential benefits outweigh the risks for individual patients and after a discussion of known risks and realistic benefits with patients.”
Reframing Low Back Pain Treatment
There is definite shift in how doctors and patients view treating low back pain. Steven Atlas, an associate professor at Harvard Medical School who practices at Massachusetts General Hospital, applauds the new guidelines, and states, “We are moving away from simple fixes like a pill to a more complex view that involves a lot of lifestyle changes.”
Fortunately, there is a gambit of healthy ways to treat your low back pain. The ACP lists several non-drug options, including heat wraps, massage, yoga, exercise, multi-disciplinary rehabilitation, guided relaxation techniques, and yes, you guessed it, acupuncture. These great alternative therapies will not only provide pain relief, but also help you live a more active lifestyle.
But We Knew This, Right? Acupuncture to Treat Low Back Pain
I know it’s easy to reach for a pill. But all pills have some risks associated with use, especially when used in higher dosages or when used regularly. Acetaminophen puts your liver at risk. And NSAIDs can cause stomach or intestinal bleeding or heart attack or stroke. Plus, you are only masking the symptom, not fixing the problem. Why turn off the fire alarm if you aren’t going to also try to put out the fire?
It’s great to see that changes in policy guidelines are being offered to conventional medicine practitioners, based on evidence. Though this is the U.S. guidelines, it’s this kind of shift in understanding that can lead to changes in how we deliver healthcare, financially support treatment options, and eventually also improve the health of more and more people. We still have a way to go, but for this one update, I say “Hooray!”More