The Rheumatologist
COVID-19 NewsACR Convergence
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Gout Resource Center
      • Axial Spondyloarthritis Resource Center
      • Psoriatic Arthritis
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Don’t Reach for Pills for Most Chronic Low Back Pain

Don’t Reach for Pills for Most Chronic Low Back Pain

February 14, 2017 • By Andrew M. Seaman

  • Tweet
  • Email
Print-Friendly Version / Save PDF

(Reuters Health)—People should try non-drug treatment options like massage or stretching for most cases of chronic low back pain before choosing treatment with over-the-counter or prescription drugs, according to new guidelines from the American College of Physicians (ACP).

You Might Also Like
  • Being Active May Reduce Risk of Chronic Low Back Pain
  • Mind-Body Therapy Helps Ease Chronic Low Back Pain
  • Antidepressant of No Clear Value in Chronic Low-Back Pain

If the pain began recently, the guidelines recommend superficial heat, massage, acupuncture or spinal manipulation. If patients wish to take medication, they should use non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, or skeletal muscle relaxants prescribed by a doctor. Acetaminophen and steroids are not recommended for low back pain, according to the guidelines.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

But for chronic low back pain—defined as pain that’s lasted more than 12 weeks—the ACP recommends people hold off on medications.

The new guidelines, online Feb. 13 in Annals of Internal Medicine, apply to low back pain that does not radiate to other parts of the body like the legs, says ACP President Dr. Nitin Damle of the Alpert Medical School of Brown University in Providence.1

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Patients with low back pain that radiates to other parts of the body need further evaluation, he tells Reuters Health.

Low back pain is one of the most common reasons people visit U.S. doctors’ offices each year. About a quarter of U.S. adults report low back pain at least one day during the previous three months.

“Most back pain is self-limited,” says Dr. Damle. “It’s common, will go away given enough time and patients can help themselves initially by trying some heat and stretching before going to see a physician.”

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

The new guidelines are based on a review of studies that looked at the use of drug and non-drug therapies for acute, subacute and chronic low back pain. The review did not look at creams or injections, however.

Based on the review, the ACP recommends that people who have been suffering with chronic low back pain try non-drug therapies, such as exercise, acupuncture, mindfulness-based stress reduction, tai chi, yoga, biofeedback, cognitive behavioral therapy or spinal manipulation.

If those methods don’t work, the guidelines say the next step should be NSAIDs or the pain medications duloxetine, which is marketed as Cymbalta, or tramadol, which is marketed as Ultram.

Opioids should only be considered as last resorts, and only prescribed after doctors discuss their risks and benefits with patients.

“If you’re going to have to use opioids, use them in the smallest dose possible with the least frequency and smallest prescription,” says Damle.

The new recommendations are very reasonable, says Dr. Joel Press, who is physiatrist-in-chief at the Hospital for Special Surgery in New York.

Pages: 1 2 | Single Page

Filed Under: Conditions, Soft Tissue Pain Tagged With: Back pain, Opioids, Pain, Pain Management, Pain Medication

You Might Also Like:
  • Being Active May Reduce Risk of Chronic Low Back Pain
  • Mind-Body Therapy Helps Ease Chronic Low Back Pain
  • Antidepressant of No Clear Value in Chronic Low-Back Pain
  • Spinal Manipulation Might Help Ease Acute Low Back Pain

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use / Cookie Preferences

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2023 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)