Recommended Treatment for Back Pain

Over any 3-month period about 25% of Americans will have low back pain. It is the top cause of disability around the world.

Unfortunately, even though low back pain is common, treatment for low back pain often fails to reflect evidence-based guidelines, leading to over treatment—including unnecessary surgery or opioid prescription.

So what are the best approaches for back pain?

In March 2018, The Lancet noted that the guidelines are evolving: now there is "less emphasis on pharmacological and surgical treatments" and greater emphasis on "self-management, physical and psychological therapies, and some form of complementary medicine."

If you experience back pain not related to an acute injury, here's what you should consider:

Recommended

Movement (including exercise and physical therapy)
Remaining active is usually preferable to rest and inactivity. Physical therapists are movement experts who can prescribe exercise programs to meet individual goals and needs.

Education
Understanding pain and getting tips to self-manage pain can be beneficial for any kind of chronic pain.

Cognitive behavioral therapy
This can be beneficial for any kind of chronic pain.

Sometimes appropriate

Yoga
Since yoga involves movement, it may be beneficial, though it should be combined with recommended treatments.

Massage
Some patients feel short-term relief, but active movement-based therapy is more beneficial long term. This should be combined with recommended treatments.

Acupuncture
Some patients feel short-term relief, but active movement-based therapy is more beneficial long term. This should be combined with recommended treatments.

Spinal Manipulation
Some patients feel short-term relief that can improve function. This should be combined with other recommend treatments, particularly exercise and active treatments.

Rarely appropriate

Opioids
The Centers for Disease Control and Prevention guidelines recommend opioids for chronic pain only after lower risk treatments have been tried, and then only when dosed appropriately and combined with nonopioid treatments.

Heat
Some patients feel short-term relief, but there is limited evidence to suggest significant long-term benefits. This should be combined with recommended treatments.

Imaging scans (such as x-rays and MRIs)
Imaging is not recommended for routine treatment of low back pain and often leads to unnecessary treatment.

Spinal injections
Injections do not appear to provide long-term benefits or reduce the likelihood of surgery.

Surgery
Surgery is not recommended for most back pain.

Not appropriate

Bed rest
Bed rest and other inactivity can make back pain worse.

If you have been experiencing back pain, schedule an appointment with us today! You can schedule online, or call our office at (574) 318-4956.