The American College of Physicians recently put out new guidelines on the treatment of low back pain. These guidelines reinforce the fact that non-pharmacologic and non-invasive methods should be the first line of treatment in both acute and chronic low back pain.
The new guidelines can be summarized by three major recommendations.
- ACUTE low back pain should be treated with heat, spinal manipulation, acupuncture and/or massage. If pharmacologic treatment is desired, NSAIDs or muscle relaxants should be selected.
- CHRONIC low back pain should initially be treated by non-pharmacologic means using exercise, multidisciplinary rehabilitation (e.g. chiropractic, physiotherapy, massage therapy), acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, behavioural therapy, or spinal manipulation.
- CHRONIC low back pain that does not respond well to non-pharmacologic therapy should consider NSAIDs as first-line therapy or tramadol or duloxetine as second-line therapy. Opioids should be considered only after failure of all other treatment methods with proper weight of risks vs. benefits and with proper discussion of these risks and benefits with the patient.
What does this mean for you, the patient?
If you are experiencing acute or chronic low back pain, your first stop should be a visit to the person who can give you a diagnosis and treat you as per the guidelines above. Chiropractors spend 4 years, after completing an undergraduate degree, learning to diagnose and treat musculoskeletal complaints, with a large focus on the spine. Chiropractors are highly trained in spinal manipulation, massage-like techniques, rehabilitative exercise and the use of many modalities for pain relief that are included in the guidelines above. Many chiropractors continue with further education and are able to use acupuncture as well.
Co-management with your medical doctor is possible as well if pharmacologic care is desired or required.
Of course, if your chiropractor determines your low back pain is due to something other than the joints, muscles or nerves in the area, they are trained to know what to look out for and when to refer out so you receive the care you need.
If you’re suffering with back pain, come to Lawrence Park Health Clinic and meet one of our skilled chiropractors! Our goal is to get you back to the things you love doing as quickly as possible. We want to get you moving and feeling good!
Author: Dr. Allie Dennis, B.Sc. Kin (Hons.), D.C., Acu, CSEP-CPT, SFMA
Toronto Chiropractor | Acupuncture Provider | Personal Trainer | SFMA Practitioner