Low back pain should initially be treated with non-drug therapies such as massage, acupuncture, exercise or yoga, according to new guidelines from the American College of Physicians (ACP).
The guidelines were published in the Annals of Internal Medicine and were developed by the ACP to present evidence and clinical recommendations on non-invasive treatment for acute and subacute low back pain.
Low back pain is a very common condition, affecting around one in ten people worldwide. It is also believed to be the most common form of disability. Pain that lasts for less than four weeks is considered acute, while pain experienced between four and 12 weeks is sub-acute. Pain lasting longer than this is considered chronic.
The ACP recommends the use of massage, acupuncture, superficial heat or spinal manipulation for acute and subacute low back pain and for chronic low back pain to be initially treated with non-drug therapies. The therapies highlighted include exercise, acupuncture, mindfulness-based stress reduction, tai chi, yoga and biofeedback. This is because they are considered non-harmful and inexpensive. the guidelines also outline the need for physical therapies to be administered by practitioners with appropriate training.
The guidelines were based on research from a systematic review of randomised controlled trials and systematic reviews published on noninvasive and non-pharmacological treatments of nonradicular low back pain.