Updated May 6, 2020
The American College of Physicians (ACP) has issued 聽that recommend massage and acupuncture over drugs. Low back pain is the 5th most common reason for doctor visits by Americans,聽with about a quarter of all US adults reporting low back pain in the past 3 months alone.
罢丑别听 recommends massage, acupuncture, taiji, yoga,聽and other non-pharmacologic聽treatments as the first treatments of choice聽for low聽back pain, suggesting drugs such as aspirin or ibuprofen only if initial non-drug treatments don’t work. The prescription聽of stronger drugs is discouraged unless all other options have failed.
鈥淧hysicians should reassure their patients that acute and subacute low back pain usually improves over time regardless of treatment,鈥� said Nitin S. Damle, MD, MS, MACP, president of the ACP. 鈥淧hysicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients.鈥�
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Reassessment of Medication Efficacy and Alternative Approaches
Acetaminophen was , but evidence collected over the past decade reverses聽that recommendation. No difference was found聽between acetaminophen and placebo for either reduction of pain聽or improvement of function over the course of聽a month.聽This reflects聽recent findings from double-blind controlled trials such as an聽. Aspirin and other NSAIDs resulted in only a small improvement. In general, in this new study, Western medical tests and treatments for low back pain were found to be highly variable,聽inexplicable, and sometimes expensive,聽but most resulted in similar outcomes. The 2007 guideline did not even assess some non-pharmacologic options such as mindfulness-based stress reduction and聽taiji.
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