American College of Physicians Guidelines on Treatment of Low-Back Pain Recommend Complementary Health Approaches
By Evelyn Cunico, MS/LIS
Posted May 27, 2017
In February 2017, the American College of Physicians (ACP) released new clinical practice guidelines on treatments for low-back pain. The title is, Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians.
The ACP Guidelines on Treatment of Low-Back Pain recommend that physicians should consider turning first to non-medication and non-surgical treatments for patients with low-back pain.
For example, the ACP Guidelines include recommendations for physicians to consider unconventional interventions, such as, complementary health approaches, including tai chi or acupuncture, before considering current treatments, such as overuse of drugs or surgery.
In general, clinical practice guidelines identify and describe recommended courses of treatment. Guidelines are not statements that must be followed, but are meant for physicians and other primary care providers to consider.
The ACP Guidelines are clear that the evidence for the benefit of complementary practices for back pain is a work in progress.
Still, the ACP Guidelines are very important, because ACP is suggesting major changes in the treatment of a common and costly clinical problem.
Low back pain is one of the most common reasons for physician visits in the United States, according to the ACP Guidelines. Most Americans have experienced low-back pain. The total costs of low-back pain in the United States exceed $100 billion per year. Two-thirds of these costs are indirect, due to lost wages and reduced productivity.
The ACP Guidelines relied in part on research conducted by the National Center for Complementary and Integrative Health (NCCIH), which is the National Institute of Health (NIH) agency with primary responsibility for research on promising health approaches that already are in use by the American public.
For information from NCCIH on health care guidelines, visit the March 02, 2017 NCCIH Research Blog, titled, New ACP Clinical Practice Guidelines on Non-pharmacologic Treatment of Low-Back Pain, by NCCIH Director Josephine P. Briggs, M.D.
For more information on low-back pain, see the Selected Information Resources following this blog post.
Editorial note: By definition, Acute back pain lasts less than four weeks. Subacute back pain lasts four to twelve weeks. Chronic back pain lasts more than twelve weeks.
Disclaimer: The information presented in this blog should not replace the medical advice of your medical doctor. You should not use this information to diagnose or treat any disease, illness, or other health condition without first consulting with your medical doctor.
Selected Information Resources
American College of Physicians. Annals of Internal Medicine. Clinical Guidelines. April 04, 2017. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians
Summary Note: Published: Annals of Internal Medicine. 2017;166(7):514-530. DOI:10.7326/M16-2367. Published at www dot annals dot org on 14 February 2017.
(Accessed 06 Ma7 2017)
Devo, RA, Mirza, SK, Martin, BI. Back Pain Prevalence, and Visit Rates: Estimates from U.S. National Surveys, 2002. Spine. 2006 Nov. 1;31(23):2724-7.
Summary Note: Summary of published data from the 2002 National Health Interview Survey (NHIS) on the prevalence of back pain, and comparison with earlier surveys. Results show that about one-quarter of U.S. adults report low-back pain in the past three months.
(Accessed Abstract 24 May 2017)
Katz, JN. Lumbar Disc Disorders and Low-Back Pain: Socioeconomic Factors and Consequences. The Journal of Bone and Joint Surgery. American volume. 2006 April;88 Suppl. 2:21-4.
Summary Note: Discusses socioeconomic risk factors for low-back pain in the United States. Examines total costs of low-back pain, including indirect costs due to lost wages and reduced productivity. As costs exceed $100 billion per year, underscores importance of identifying strategies to prevent low-back pain disorders.
(Accessed Abstract 24 May 2017)
Mayo Clinic. Healthy Lifestyle. Adult Health. Back Pain at Work: Preventing Pain and Injury.
Summary Note: Discusses factors that contribute to back pain in various types of work environments. Suggests ideas on how to help prevent pain at work.
(Accessed 22 May 2017)
National Institutes of Health. National Center for Complementary and Integrative Health. Five Things to Know about Chronic Low-Back Pain and Complementary Health Practices
Summary Note: Discusses what the science says about various complementary treatment options for chronic low-back pain.
(Accessed 06 May 2017)
National Institutes of Health. National Center for Complementary and Integrative Health. NCCIH Research Blog. March 02, 2017. New ACP Clinical Practice Guidelines on Non-pharmacologic Treatment for Low-Back Pain.
Summary Note: Josephine P. Briggs, M.D., Director, National Center for Complementary and Integrative Health, discusses the Guideline titled, Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians, published online on 14 February, 2017.
(Accessed 06 May 2017)
National Institutes of Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Handout on Health: Back Pain.
Summary Note: The National Institute of Arthritis and Musculoskeletal Diseases is the primary NIH organization for research on back pain. Consumer Handout describes back pain causes, diagnosis, treatments, and research efforts.
(Accessed 23 May 2017)
National Institutes of Health. U.S. National Library of Medicine. MedlinePlus Back Pain.
Summary Note: Resource includes links to more than 100 reliable websites. Subheadings include Diagnosis, Prevention, Treatments, Videos, Statistics, Clinical Trials, Journal Articles, Women, and Children. Sections also include, Find an Expert, Patient Handouts, and Medical Encyclopedia.
(Accessed 24 May 2017)
National Institutes of Health. U.S. National Library of Medicine. MedlinePlus. Medical Encyclopedia. Taking Care of Your Back at Home
Summary Note: Article offers tips on how to handle back pain, including lists of activities that should be practiced or avoided during back pain recovery at home.
(Accessed 12 March 2017)