Low Back Pain Treatment: Changes To International Guidelines = Don’t Expect Pain Meds

Recent changes to international guidelines for low back pain treatment suggest that family doctors may be much less likely to prescribe pain medication, which has been used previously as a first line of defense.

The new guidelines, which include the UK National Institute for Health and Care Excellence clinical guideline for low back pain and sciatica, and a clinical practice guideline from the American College of Physicians, come as a response to the opioid epidemic and may result in a sea change in approaches to low back pain treatment.

Indeed, research has uncovered little evidence that painkillers are actually effective for people with low back pain (LBP), and in fact, most findings have found evidence to the contrary. Moreover, instead of pain medication, general practitioners may recommend alternative treatments such as mindfulness, yoga, physiotherapy, or psychotherapy.

Low back pain is the #1 cause of disability globally, and it is the second most common reason for family doctor visits.  The results of a University of Sydney review that investigated the current approach and changes to diagnosis and management of lower back pain were subsequently published in the Canadian Medical Association Journal.

Lead author Dr. Adrian Traeger, a researcher at the University’s School of Public Health, per ScienceDaily:

“These new guidelines suggest avoiding pain medicines initially and discouraging other invasive treatments such as injections and surgery.”

“If you have an uncomplicated case of recent-onset LBP, your doctor may now simply provide advice on how to remain active and non-drug methods for pain relief such as heat and massage…”

Also, he states, for long-term pain, your doctor might recommend “treatments such as yoga, exercise or mindfulness” and other options may include “spinal manipulation, acupuncture, or multi-disciplinary rehabilitation programs.”

“These revisions to major international guidelines should see changes to practice worldwide.”

~ G. Nathalee Serrels, M.A., Psychology

References

https://www.sciencedaily.com/releases/2017/11/171115091753.htm

http://www.cmaj.ca/content/189/45/E1386