New Physician Guidelines Say No Drugs for Back Pain
Fueled by the ever-emerging opinion of many doctors that opioids, such as oxycodone, are being overprescribed – and even serving as a gateway for opioid addicts’ transition to heroin – more and more doctors are prescribing alternatives such as chiropractic for acute and long-standing lower back pain.
Pain in the low back is one of the top reasons people visit a doctor with more than 80% of the population experiencing it in their lifetime.
Now, new guidelines from the American College of Physicians are stating that acute and chronic back pain is best treated without drugs.
Per the new guidelines, initial care should be non-drug in nature with medications serving as the alternative rather than the initial method of intervention.
Approaches recommended by the new guidelines includes massage, acupuncture and chiropractic care.
The guidelines say that drug therapy (especially using opioids) should be the last option for treatment and only considered for chronic back pain when other natural and less addictive drug options don’t work. 1
Lower back pain is the leading cause of missed days on the job and work related disability. 2
The most common cause of back pain involves dysfunction in the way spinal joints and/or spinal discs are moving or functioning.
This loss of proper motion (called a ‘subluxation’) results in irritation and inflammation of nearby nerves which can ultimately lead to pain.
While it can occur due to sudden onset triggered by something as seemingly innocuous as bending of lifting, in most cases the underlying condition has developed over time due to age-related changes of the spine and disc degeneration per the National Institutes of Health.
Other contributing factors that put an individual at greater risk for suffering back pain are lack of exercise, poor diet that includes sugar and other inflammatory foods, weight gain, old injuries and prolonged periods of poor posture – such as being hunched over a computer for hours on end.
AUTHORS NOTE: It is great to see the impact that ‘alternative’ care such as chiropractic get brought to light in a prominent article. However, both the author of the article and the American College of Physicians is not well informed on what the research shows regarding the impact chiropractic care can have not only on acute but also chronic longstanding lower back conditions.
Numerous studies show that chiropractic is much more effective than medical intervention to treating lower back pain. I have cited a few below.
Resources: Sumathi Reddy. The Wall Street Journal. Feb. 13, 2017.
- Annals of Internal Medicine
- National Institute of Neurological Disorders and Stroke
Studies Show Chiropractic Care as Superior for Treatment of Lower Back Pain
A study of 283 patients with chronic low back and leg pain were given 2 to 3 weeks of chiropractic adjustments. 81% of patients with referred pain achieved a “good” result defined as symptom-free to mild intermittent symptoms but with “no restrictions for work or other activities.”
Note – these patients had experienced failed results with previous conservative and/or operative procedures and in most cases considered completely disabled.
Kirkaldy-Willis WH, Cassidy JD; Spinal Manipulation in the Treatment of Low Back Pain; Canadian Family Physician, March 1985, Vol. 31, pp. 535-540
A randomized comparison of chiropractic and hospital outpatient treatment for low back pain published in the prestigious British Medical Journal found “Chiropractic treatment was more effective than hospital outpatient management, mainly for patients with chronic or severe back pain.”
Meade TW, Dyer S, Browne W, Townsend J, Frank OA; Low back pain of mechanical origin: Randomized comparison of chiropractic and hospital outpatient treatment; British Medical Journal; Volume 300, June 2, 1990, pp. 1431-7.
A 2003 study published in the highly regarded orthopedic journal called SPINE published a study showing that chiropractic was over 5 times more effective than medications and more than 2 times as effective as acupuncture in the treatment of chronic spine pain.
Muller R, Lynton G.F. Giles LGF, DC, PhD; Long-Term Follow-up of a Randomized Clinical Trial Assessing the Efficacy of Medication, Acupuncture, and Spinal Manipulation for Chronic Mechanical Spinal Pain Syndromes; Journal of Manipulative and Physiological Therapeutics, January 2005, Volume 28, No. 1.
A 2011 study in Spine found that maintenance adjustments to the spine provided better long-term results for managing pain and function ability in those with chronic lower back conditions.
Senna MK1, Machaly SA.: Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome?, Spine 2011 Aug 15;36(18):1427-37. doi: 10.1097/BRS.0b013e3181f5dfe0.