Low back pain? Try drug-free options first

At some point in our lives, 80 per cent of us will experience some sort of back pain – and it’s often the head-scratching kind, when it’s not obvious what the heck you did to bring it on.

It used to be that no matter what the cause, over-the-counter painkillers like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) were the go-to treatments. Just pop a couple of those and you’re set, right?

Well, it turns out that low back pain in particular just isn’t that simple. That’s something we integrative doctors have been saying for a while – but now the mainstream American College of Physicians finally seems to agree.

Its new guidelines for alleviating back pain don’t involve medication at all – but, rather, some of the non-drug therapies that doctors like me have been touting for ages.

Back pain is one of the toughest complaints to treat, since it can come from a variety of root causes. And muscle pulls will respond differently to treatment than pain that’s cause by inflammation.

The new guidelines are based on a growing body of evidence that suggests that short-term pain – lasting fewer than 12 weeks can be eased without drugs by therapies including heat wraps, massage, acupuncture, and spinal manipulation.

These natural approaches can also moderately restore any loss of back function.

Even if your pain has lasted more than three months, the American College of Physicians still recommends drug-free treatments including exercise therapy, acupuncture, yoga, tai chi, mindfulness-based stress reduction, and guided relaxation techniques.

The new guidelines are a departure from the previous ones that recommended paracetamol as a first-line treatment, NSAIDs as a second, and opioids as a third.

But recent research has shown that NEITHER acetaminophen nor NSAIDs are clinically effective for most low back pain! Even opioids have only minimal impact while posing risks of addiction and accidental overdose.

And that’s why pharmaceutical painkillers should only be used as a last resort.

So, when you wake up with that puzzling crick in your back, don’t reach for a bottle – at least, not right away. (Most acute back pain will improve over time anyway, regardless of treatment.)

Out of all of the new guidelines, I recommend trying a yoga class. It combines gentle physical movements with breathing and meditation, and studies have shown it to both reduce back pain and improve function.

If getting into a “downward dog” position is a bit too much for you, there are other, more hands-on ways to work out the kink with the help of an acupuncturist, massage therapist, or chiropractor.

As a certified medical acupuncturist myself, I’ve seen first-hand the way that this ancient Chinese therapy can relieve my patients’ pain.

Wishing you the best of health,

Dr. Glenn S. Rothfeld
Nutrition & Healing

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Try Drug-Free Options First for Low Back Pain, New Guidelines Say, medlineplus.gov/news/fullstory_163555.html

Low Back Pain? Relax, Breathe and Try Yoga, medlineplus.gov/news/fullstory_163537.html

What’s the Role of NSAIDs in Back Pain?, medpagetoday.com/rheumatology/backpain/62958

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