It is always interesting when “new” findings come out in medical journals and hit the news. Just this past week a “groundbreaking” guideline was issued by the American College of Physicians that trying noninvasive treatment first for low back pain has been found to be effective for reducing pain.

This guideline was published based on a review of trials evaluating the clinical outcomes of reduction or elimination of low back pain, improvement of back pain and function, improvement of health and quality of life, reduction in work disability, and patient satisfaction.

Three recommendations were given for physicians to treat and prescribe care for patients with acute, subacute, or chronic low back pain. The first is to try noninvasive methods before pharmaceuticals or surgery. This recommendation was suggested because most patients with back pain improve over time regardless of treatment. Physicians should also prescribe nonpharmacologic treatment, such as acupuncture, massage, or spinal manipulation, but if stronger intervention is indicated, nonsterioidal (NSAIDs) should be chosen before prescribing stronger pain medication.

The second recommendation is that patients try nondrug treatment, for example, exercise, rehab, acupuncture, mindfulness-based stress reduction, tai chi, yoga, progressive relaxation, biofeedback, low-level laser therapy, and spinal manipulation.

The third recommendation is that patients who do not have an adequate response or reduction in pain from the noninvasive therapies should consider nonsterioidal anti-inflammatory drugs as first-line therapy, AND that physicians should only consider opioids as an option if patients have failed to improve with the other therapies. The article states, “Low-quality evidence showed no difference in pain or function between a single intramuscular injection of methylprednisolone or a 5-day course of prednisolone compared with placebo in patients with acute low back pain.”

What does all this mean?

This is really important! What it means is that mainstream medicine is realizing that drugs are being overprescribed and may not be indicated in certain circumstances. This country is seeing an epidemic in overprescription of pain medication and the possible addiction that comes with it. In my office, when patients come in for acupuncture, most of the time they are already on pain medication and have been for months, even years, and are either not getting better or are still experiencing high levels of pain, and their quality of life is being affected. Acupuncture should not be the “backup plan” or chosen because everything else has failed. Instead, it should be the FIRST line in the treatment plan so that patients can get better FASTER!

As a naturopathic physician, I learned in school to start with the lowest force intervention first (if indicated), and, in fact, patients get better faster, start sleeping again, have more energy, and can get back to living! This new set of guidelines is important because mainstream medicine is now understanding what needs to be done. What the body needs is a push to heal itself. That is what our body is designed to do anyway, and lower force interventions, such as acupuncture, do work! It is also significant that the effectiveness of mindfulness and relaxation has been recognized because we already know the importance of the power of the mind and stress reduction in improving the quality of life and reducing pain.

I am really proud that Western medicine now seems to be putting patients first and not the drug companies!

Now go get some acupuncture!

Source:

Qaseem A, Wilt TJ, McLean RM, Forciea MA, for the Clinical Guidelines Committee of the American College of Physicians. “Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians.” Ann Intern Med. [Epub ahead of print 14 February 2017] doi: 10.7326/M16-2367