Back pain Treatment and Prevention
Conservative Treatment Options Supported by Research
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Published in 2017 in the Annals of Internal Medicine and based on a review of randomized controlled trials and observational studies, the ACP guidelines cite heat therapy, acupuncture, and spinal manipulation (a centerpiece of chiropractic care) as possible options for non-invasive, non-drug therapies for low back pain. Only when such treatments provide little or no relief, the guidelines state, should patients move on to medications such as ibuprofen or muscle relaxants, which research indicates have limited pain-relief effects. According to the guidelines, prescription opioids should be a last resort for those suffering from low back pain, as the risk of addiction and overdose may outweigh the benefits.
Back Pain Guidelines
References: 1. Rubin Dl. Epidemiology and Risk Factors for Spine Pain. Neurol Clin, 2007; May;25(2):353-71. 2. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016 Oct 7; 388:1545–1602.Qaseem A, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians. Ann Intern Med, 2017;166(7):514-530. 3. Machado GC, et al. Non-steroidal Anti-inflammatory Drugs for Spinal Pain: A Systematic Review and Meta-analysis. Annals of the Rheumatic Diseases. Published online first, Feb. 2, 2017; doi: 10.1136/annrheumdis-2016-210597 4. Michaleff ZA, et al. Spinal Manipulation Epidemiology: Systemic Review of Cost Effectiveness Studies. J Electromyogr Kinesiology, Oct 2012; 22(5):655-652. 5. Keeney et al. Early Predictors of Lumbar Spine Surgery after Occupational Back Injury: Results from a Prospective Study of Workers in Washington State. Spine, 2013; 38(11):953-964.
In March 2016, the Centers for Disease Control and Prevention released updated guidelines for prescribing opioids that also promote the use of non-pharmacologic alternatives for the treatment of chronic pain. In 2015, the Joint Commission, the organization that accredits more than 20,000 health care systems in the U.S. (including every major hospital), recognized the value of non-drug approaches to pain management by adding chiropractic and acupuncture to its pain management standard.
The epidemic of prescription opioid overuse and abuse has also led many health groups to reconsider the value of a conservative approach to common conditions such as back pain. For example, the American College of Physicians (ACP), the largest medical-specialty society in the world, updated its back pain treatment guidelines to support a conservative approach to care.
Sometimes back pain is sharp and intense, caused by a wrong movement or an injury, and heals in a few days or weeks. Others experience back pain as a chronic condition, seriously altering their ability to work and enjoy time with family, friends and other leisure activities, and leading to depression in some cases. A recent global survey of health conditions identified back pain as the single most disabling condition worldwide.
Moreover, as lifestyles have become more sedentary and the rate of obesity has risen, back pain has become increasingly prevalent, even among young children. Spinal health is an important factor in preventing back pain, as well as maintaining overall health and well-being. The American Chiropractic Association (ACA) encourages people to take steps to improve their spinal health and avoid injury. Things such as better nutrition, exercise, ergonomic work spaces and proper lifting and movement techniques can go a long way in helping people to strengthen their spines and potentially avoid serious injury and chronic pain. When back pain hits, research shows that a conservative approach to treatment is the best option.
Treatment for back pain has come a long way. It was once believed that taking pain medication and getting some rest and relaxation were the best course of action for a bout of low back pain, but nowadays research supports first trying drug-free, conservative options for pain management while remaining as active as possible during recuperation.
Back pain is a fact of life for many people. Research shows that up to 80% of the population will experience back pain at some point during their lives.
It is also one of the most common reasons for visits to the doctor’s office.
Chiropractic is a healthcare profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic services are used most often to treat conditions such as back pain, neck pain, pain in the joints of the arms or legs, and headaches. Chiropractors practice a hands-on, drug-free approach to health care that includes patient examination, diagnosis and treatment. Widely known for their expertise in spinal manipulation, chiropractors are also trained to recommend therapeutic and rehabilitative exercises, and to provide nutritional, dietary and lifestyle counseling.