American College of Physicians Recommends Massage and Acupuncture for Low Back Pain
In February, the American College of Physicians (ACP) issued new guidelines for treating low back pain that recommend massage, acupuncture and other non-pharmacologic treatments as the first treatments of choice, suggesting drugs such as aspirin or ibuprofen only if initial non-drug treatments don’t work. The prescription of stronger drugs is discouraged unless all other options have failed.
“Physicians should reassure their patients that acute and subacute low back pain usually improves over time, regardless of treatment,” says Nitin S. Damle, M.D., MS, MACP, president of the ACP. “Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients.”
Acetaminophen was strongly recommended as a first-line medication in ACP 2007 guidelines, but evidence collected over the past decade found no difference between acetaminophen and placebo for reduction of pain or improvement of function, which reflects recent findings from double-blind controlled trials. In general, the new study found that Western medical tests and treatments for low back pain were highly variable, inexplicable and sometimes expensive, but most resulted in similar outcomes as compared to treatments such as acupuncture or massage.
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