Noninvasive treatment guidelines for acute, subacute and chronic low back pain
This week the American College of Physicians updated their recommendations and guidelines on what the most appropriate noninvasive (no injections or surgery) treatments are for acute, subacute, and chronic low back pain. At Sydney Spine & Sports Centre (S3C) our Balmain and Rozelle chiropractors and physiotherapists pride themselves on offering the very best in noninvasive treatments and non-drug treatments for low back pain that are based on the latest evidence and research from both national and international sources. Our chiropractors have summarised their recommendations in clear and easy to understand language.
Now, before our chiropractors run you through the recommendations some general principles should be expressed. Non-drug options should always be trailed before drug options. If it is on this list, it does not mean its right for your type of low back pain. It is of grand importance that you go and see your chiropractor or physiotherapist to see which non-drug treatment will be ‘right’ for you. For example, yoga may not be right for you but a walking program that is paced may be. Chiropractors and physiotherapists do not give drug advice, we have only included these for completeness and to reflect on the guidelines in their entire capacity. There is no substitute for advice, education and reassurance when it comes to low back pain. Go and see you chiropractor or physiotherapist and first have a chat, and discuss your problem. Healing starts with a conversation.
For acute and subacute low back pain, the most appropriate treatments include.
Non-drug (pharmacologic) treatments (used first)
- Heat therapy treatments
- Acupuncture/dry needling
Drug (pharmacologic) treatments
- Nonsteroidal anti-inflammatory drugs
- Muscle relaxants
For chronic low back pain, non-drug (pharmacologic) treatments should be used first, and include
- Exercise (walking etc.)
- Rehabilitation exercises
- Acupuncture/dry needling
- Mindfulness-based stress reduction
- Tai chi and/or yoga
- Exercises that work on control (motor control exercise)
- Relaxation exercises
- Electromyography biofeedback
- Low-level laser therapy
- Operant therapy
- Cognitive behavioural therapy
- Spinal manipulation
For chronic low back, only individuals who have not found adequate relief from non-drug treatments (above) should use drugs.
Appropriate drug (pharmacologic) treatments
- Nonsteroidal anti-inflammatory drugs as first-line therapy
- Tramadol or duloxetine as second-line therapy
- Opioids should only be considered as an option in patients who have failed the above treatments and only if the potential benefits outweigh the risks for individual patients and after a discussion of known risks and realistic benefits with patients.
At Sydney Spine & Sports Centre (S3C), our chiropractors and physiotherapists are passionate about providing you with the two most important treatments for low back pain. These include
- and advice.
Our Balmain and Rozelle chiropractors provide the most current and up-to-date information to inform your decision making process and reassure you that what we do is based on the latest evidence and guidelines.Give us a call today and let one of our chiropractors in Balmain and Rozelle help you with your recovery from back pain.