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New guidelines help self-manage back pain without medication

| Monday, March 27, 2017, 11:00 p.m.

The American College of Physicians on Feb. 14 released new guidelines for the management of low back pain for physicians. Now bear in mind, this has to do with simple back pain, not those cases that include pain down the leg or sciatica.

Due to the high rate of opiate addiction and its adverse effects, physicians are advised to provide non-steroidal anti-inflammatory drugs and muscle relaxants instead.

But not to fear, there are many things that can be done other than take medication to manage back pain.

These physician guidelines also include advice to patients (with both acute and subacute back pain), to try “superficial heat, massage, acupuncture, or spinal manipulation.”

This places the onus on the patient to self-manage rather than seek medication which is a shift in back pain management. As a physical therapist, my advice for anyone suffering from back pain is this: If your pain goes away in five to seven days, then your self management tactics have worked. If they do not, then it is time to seek either a physical therapist's assistance or another medical professional you trust. This is my opinion based on my years of experience. Sometimes back pain simply needs more directed care. But do find someone that treats the back on a regular basis so you get specific, targeted care.

Within the guidelines, the other interventions they recommended for chronic back pain suffers included “exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor control exercise (MCE), progressive relaxation, electromyography biofeedback, low level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation”. This is quite a diverse and lengthy list. You can find an in-depth description of these interventions here:

Health care costs are on the rise and part of this move to patient self-management is to address the overall cost of back pain. With as many as 1 in 10 people suffering from back pain, the cost to both patients and insurance companies continues to go up. Although it may seem as if the guidelines are limiting, this actually enables patients with choices and self-directed care.

In the long run, this may help patients get better faster and decrease downstream costs of health care that may not have been needed. It is a good thing.

However, this shift in management of back pain is not necessarily embraced by all practitioners just yet.

As with any change, it takes time for full implementation. Thus, if you happen to be that person who needs simple back pain management, you may want to do a little bit of research on the people you choose to assist you.

Nuket Curran has been a physical therapist for nearly 20 years and educator in health care for over a decade. Her physical therapy and fitness practice, Fightin' Fit Physical Therapy, LLC., offers customized PT and fitness programs. She can be reached at

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