“Take two of these and call me in the morning” is no longer the standard for low back pain, in this next Back & Body video. Dr. Dave Perna here with Back & Body Medical your collaborative care for chiropractic, physical therapy and acupuncture. Treating the patients in New York City in Midtown, Manhattan on 58th and Lexington as well as in Springfield, New Jersey on Route 22 in Springfield, treating patients of Summit, Westfield, Springfield, Cranford and the surrounding towns as well.
The latest study and what I mean by latest is it came out in February 2017 from the American College Physicians, they published the new guidelines for nonradicular low back pain in the Annals of Internal Medicine in the February edition. They wanted to emphasize conservative treatments. They want to say that nonsteroidal or NSAIDs should not be used as the first line of defense for acute low back pain. They find it ineffective and they have said that other therapies have been more helpful and with everything being equal, at the very least, as they were taught, do no harm. They’re recommending a more conservative approach towards low back pain. They do say that there’s an acute and chronic stages and sub acute stages. The first four weeks being acute and they find there’s between the therapies like physical therapy, chiropractic and acupuncture how they describe it as spine manipulation, medical massage, and acupuncture as their most giving examples.
They say they’re all pretty equal in their abilities to reduce back pain. With those being very effective and very little risk to the patient, they find no reason to use anything else. Now this is where it gets interesting because the second stage or the sub acute stage, they then say the use of certain drugs or NSAIDs should be recommended but they’re not the typical over the counter drugs that we take in our cabinets so keep that in mind if you’re quickly reading some of this research elsewhere. They also discourage the use of opioids at that point saying that there’s a fear of accidental addiction or accidental overdose with use of opioids especially once you start getting past the first four weeks of care and a person is taking them over and over again, the likelihood of having a problem gets higher as we all can imagine if you’re constantly taking a narcotic drug to reduce your pain.
They did say that they followed up on various studies of people to come to these conclusions and they said that 30% of people who have an acute episode of back pain experience pain a year later. So almost a third of the people who have an acute episode will have ongoing discomfort pain a year later. Of the people who have an acute episode of back pain, 20% of those people report a limitation or functional limitation after a year. So, although they do mention that most people’s issues do resolve within the first 4 weeks if not the first 12 weeks, a third is a lot of people to have to deal with pain long term. So the concerns are if you start them down the road of taking drugs or opioids or even just regular NSAIDs, you’re going to run into problems long term with the overuse of them.
They do suggest a multidisciplinary approach for people experiencing chronic low back pain over time. This is very interesting and very exciting to us here at Back & Body because everything that they’re describing as treatment for care for low back pain of the nonverdicular variety is something that we do. We offer chiropractic, we offer physical therapy, and we offer acupuncture.There are different guidelines for different stages and looking through their recommended guidelines they fall right int he range of what we do at the 4, 12 and beyond 12 week patterns, for the acute, sub acute and chronic stages.
So I was just talking with Dr. Sivendra, the medical doctor here and it’s something that we do and we’ve been doing. He did mention that talking to other physicians, they’re not in his words “as trained to handle low back pain all the time” because when they’re in school they see the more significant varieties of problems because that’s what they want to be exposed to and then when they get into practice, they end up seeing more of these problems, low back pain. Low back pain is one of the most common reasons someone seeks help from a medical professional so here you are having people only used to treating with NSAIDs a letter as he put it for 2 days off of work and now the American College of Physicians is saying that is not the way to treat these problems. So if you’re dealing with acute, under 4 weeks, sub acute (under 12 weeks) or beyond 12 weeks, please keep our collaborative care of physical therapy, chiropractic and acupuncture in mind when dealing with this problem and realize that the studies now suggest that NSAIDs, the over the counter variety that you’re used to taking for discomfort have been found to be ineffective for low back pain.
