The American College of Physicians (ACP) has published their evidence-based clinical practice guidelines for treating nonradicular low back pain in the Journal Annals of Internal Medicine. The guidelines are based on a review of randomized controlled trials and observational studies conducted on noninvasive drug and non-drug treatments for low back pain.
Nonradicular pain refers to pain that does not irradiate from, and is not caused by, damage to the spinal nerve root. The pain is typically characterized as acute (lasts under 4 weeks), subacute (lasts between 4 and 12 weeks), and chronic (lasts for more than 12 weeks). Low back pain affects millions of people in the United States, and the condition is one of the most common reasons for people missing work.
The ACP last published their clinical practice guidelines in 2007. Since then, some of the evidence has changed, and the 2017 guidelines include evaluations of mindfulness-based therapies, motor control exercise (MCE), and tai chi. New guidelines from the American College of Physicians recommend noninvasive ways of treating nonradicular low back pain.
The committee recommends that patients with chronic low back pain start by undergoing non-drug therapy and exercising. Among the suggestions in the guidelines, acupuncture treatment is the one recommended for both acute and chronic lower back pain.
Dr. Nitin S. Damle, the president of the ACP comments on the newly issued recommendations:
“For the treatment of chronic low back pain, physicians should select therapies that have the fewest harms and costs, since there were no clear comparative advantages for most treatments compared to one another. Physicians should remind their patients that any of the recommended physical therapies should be administered by providers with appropriate training.”