New Medical Guidelines Advise Against Opioids For Chronic Back Pain

Low Back Pain

New guidelines from the American College of Physicians are calling for people to first try non-drug treatment options to address chronic low back pain.

The guidelines come from a review in a recent study published in the Annals of Internal Medicine. Dr. Ditin Namle, President of the ACP, told Reuters Health that medications should not be used in cases of low back pain that persists more than 12 weeks. However, this does not apply to back pain that extends to other parts of the body such as the legs. An evaluation from a medical professional should be given in these cases.

“Most back pain is self-limited,” said Damle. “It’s common, will go away given enough time and patients can help themselves initially by trying some heat and stretching before going to see a physician.”

The ACP recommends first using non-drug therapies such as exercise, acupuncture, mindfulness-based stress reduction, tai chi, yoga, biofeedback, cognitive behavioral therapy or spinal manipulation. Non-steroidal anti-inflammatory drugs, such as Ibuprofen, are also an option. If this is done without success, the next step should be NSAIDs or the pain medications duloxetine, which is marketed as Cymbalta, or tramadol, which is marketed as Ultram.

Damle said that opioids should only be considered as last-resort options and should be used “in the smallest dose possible with the least frequency and smallest prescription.”

The ACP noted that about one-fourth of US adults reported low back pain at least one day in the previous three months.