Newark, DE, March 1, 2017 – The American College of Physicians (ACP) published a new clinical practice guideline for low back pain last month, featuring expanded treatment recommendations with a strong focus on nonpharmacologic options.
Citing low-back pain as “one of the most common reasons for physician visits in the United States,” the updated guideline not only addresses the costly back pain problem, but also takes into account the growing national concern for the current opioid epidemic. Narcotic prescriptions have been facing increasing scrutiny as the number of opioid-related deaths continues to rise each year. According to the U.S Department of Health and Human Services, “more people died from drug overdoses in 2014 than in any year on record, and the majority of drug overdose deaths (more than six out of ten) involved an opioid.”
In contrast to the 2007 guideline (which contained a total of 7 recommendations), this update contains only 3, each highlighting a call for “high-value care”, whereby “clinicians should avoid prescribing costly and potentially harmful treatments for these patients, especially narcotics.”
The recommendation for patients experiencing chronic low back pain wholly excludes pharmacological intervention and instead advises, “clinicians and patients should initially select nonpharmacologic treatment” such as exercise, acupuncture, and low-level laser therapy.
For patients suffering from chronic back pain who don’t find relief from the recommended nonpharmacologic therapy, the ACP recommends they “consider pharmacologic treatment with nonsteroidal anti-inflammatory drugs as first-line therapy…” cautioning that “clinicians should only consider opioids as an option in patients who have failed the aforementioned treatments and only if the potential benefits outweigh the risks…”
The guideline, which, according to the ACP was “developed through a rigorous process based on an extensive review of the highest quality evidence available”, also points to recent evidence suggesting that both acetaminophen and systemic steroids are not as effective as previously thought for treating low back pain.
To access the complete guideline, please click here.