Sexta-feira, 24 Fevereiro, 2017

Physicians group recommends non-drug treatments for back pain

The American College of Physicians new guidelines say patients with back pain should try natural therapies for up to 12 weeks before trying over-the-counter pills or stronger opioids ACP issues new guidelines for treating low back pain; video available
Damião Vaz | 17 Fevereiro, 2017, 00:07

"What patients understand is often far from what the evidence tells us to do", said anesthesiologist Anita Gupta, who was not involved in the study.

You may be tempted to ask your doctor for prescription painkillers when you're grappling with chronic back pain.

New guidelines from the American College of Physicians show opioids should be a last resort for pain management. They find a bit more evidence to support practices like yoga for pain control.

"Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain" is based on a systematic review of randomized controlled trials and systematic reviews published on noninvasive pharmacological and non-pharmacological treatments of nonradicular low back pain.

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The recommendations come after an alarming increase in opioid overdose incidences across the country this past year, and the subsequent deaths associated with them.

But health insurance is more likely to cover pills than tai chai. However, medicines with steroid injections and acetaminophen, like Tylenol, are found to be not helpful.

Most cases are caused by lifting a heavy object badly or bending awkwardly, and in most instances will go away within a few weeks.

Studies have shown paracetamol is ineffective against back pain, and more powerful opioid painkillers are both ineffective and highly unsafe.

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Researchers noted in this guideline that evidence was insufficient to determine treatments for radicular low-back pain.

For people with low back pain, options range from exercise and a massage to acupuncture, in which a medical professional places tiny needles in the skin at certain points on the body, to spinal manipulation in which your spine is adjusted. Opioids, skeletal muscle relaxants, and systemic corticosteroids, meanwhile, appear to provide only low-to-moderate relief and only for a limited amount of time. Additional options include low-level laser therapy, operant therapy, cognitive behavioral therapy and spinal manipulation.

These include finding things in scans that look like abnormalities that really have nothing to do with the pain, getting patients hooked on powerful prescription drugs, or taking on the risks of invasive surgeries. Drugs, such as Tramadol or duloxetine are recommended as second line therapies.

"Physicians should reassure their patients that acute and subacute low back pain usually improves over time regardless of treatment", said ACP President Nitin Damle, M.D., M.S., in a news release (

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