Nearly everyone experiences back pain at some point in their lives. Back pain is one of the most common reasons for medical visits among American adults, and it is the leading cause of disability in people under the age of 45. There are several factors that can contribute to back pain, but one common cause is muscle tension from stress and anxiety.
April is Stress Awareness Month, a 30-day campaign to raise awareness about the causes and cures for stress. While we typically think of stress as a mental and emotional struggle, what many of us don’t realize is that stress can manifest itself through a number of physical symptoms such as fatigue, body aches and muscle pain.
Medication is often our first line of defense for treating back pain, but new guidelines released by the American College of Physicians (ACP) suggest a different approach. These guidelines recommend non-pharmacological therapies such as yoga, tai chi and massage for treating lower back pain, while reserving medications and prescription opioids as a last resort.
These updated guidelines come as a result of analyzing over 150 studies to determine which treatments are successful – and which ones are not – when addressing lower back pain. Evidence from this analysis indicated that acetaminophen and steroid injections, two common treatments for back pain, were not effective in improving pain outcomes.
For patients who want to use medications to control back pain, the guidelines recommend nonsteroidal anti-inflammatory drugs or skeletal muscle relaxants. However, ACP President Dr. Nitin S. Damle stresses the importance of trying non-pharmacological treatments first. For patients with chronic low back pain, the ACP recommends some of the following non-drug therapies:
- Multidisciplinary rehabilitation
- Mindfulness-based stress reduction
- Tai chi
- Motor control exercise
- Progressive relaxation
- Spinal manipulation
Patients should discuss alternative therapy options with their doctors to determine which treatment will best meet their needs. However, Damle explains that most back pain resolves itself over time regardless of which therapy is used. “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,” he said (Source: American College of Physicians).
The complete guidelines are published in the Annals of Internal Medicine.