New Low Back Pain Guidelines

Lower back pain is one of the most common reasons for visits to physicians in the United States. It can be extremely disabling, and can affect every aspect of a patient’s life, which makes it a massive drain on the economy because of lost productivity. There are three categories of lower back pain. Lower back pain that lasts under four weeks is defined as acute. If it lasts between four and 12 weeks, it’s called subacute, and if it lasts for over 12 weeks, it’s considered chronic. Until recently, the conventional clinical guidelines for the treatment of all the different types of low back pain have been grossly outdated and out of of sync with the science.

To treat lower back pain, the medical community has long relied on a variety of pharmaceutical options, many of which can have potentially dangerous side effects. However, luckily, the tide is turning towards natural, effective remedies for both acute and chronic types of lower back pain… and this is a hugely positive step forward.

Recently, the American College of Physicians released an update of their established guidelines for treating lower back pain. The American College of Physicians, or ACA, is a prestigious medical organization, and its reports alter the practice of medicine in this country. The last time these guidelines were updated was 2007… and a lot has changed in the past decade.

This ten year update on the management of low back pain has made waves in the natural medicine community, because the guidelines reflect many things natural doctors already prescribe for lower back pain. For acute lower back pain, these include:

– Massage therapy

– Heat therapy

– Spinal manipulation (chiropractic care)

– Acupuncture

For chronic lower back pain, some therapies include:

– Exercise

– Mindfulness-based stress reduction

– Yoga

– Tai chi

– Massage

– Acupuncture

– Spinal manipulation

It is remarkable and exciting that these effective natural remedies are finally being given the attention that they deserve by the medical community at large.

One important thing to keep in mind when it comes to lower back pain is that despite the fact that it can be incapacitatingly painful, it will usually resolve on its own. Because of this fact, never underestimate the power of reassurance and gentle movement as effective treatments. I am also pleased to see that the ACP’s new report discourages the use of common but more invasive treatments, such as steroids (oral and injected) and surgery.

This was a refreshing report from the ACP which makes me feel like guidelines are finally catching up to the way that naturopathic doctors have been treating low back pain for years. Summarizing the findings of the ACP in a press release, Dr. Nitin S. Damle stated:

“Physicians should reassure their patients that acute and subacute low back pain usually improves over time regardless of treatment. Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients… For the treatment of chronic low back pain, physicians should select therapies that have the fewest harms and costs, since there were no clear comparative advantages for most treatments compared to one another.”

A positive step forward, indeed.

– Dr. Joshua Levitt

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