Here ’s something completely different for low back pain
Follow me on Twitter @RobShmerling It’s a question that has challenged generations of patients and their doctors. The answer has changed over the years. When I was in medical school in the early 1980s, bedrest for a week or more was often recommended for severe back pain. This sometimes included hospital admission. Then, research demonstrated that prolonged bedrest was actually a bad idea. It was no better (and often worse) than taking it easy for a day or two followed by slowly increasing activity, including stretching and strengthening the back. Medications, including pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants were a standard part of the initial treatment of back pain. But, recommendations released in February 2017 urge doctors to change their approach to back pain once again. Didn’t I just hear that NSAIDs don’t work well for back pain? You did. A recent study found that NSAIDs did not work well for back pain. But, new recommendations take that conclusion even further: it may be best to avoid medications altogether — at least at the start. The American College of Physicians has just come out with new guidelines for the treatment of low back pain based on a review of more than 150 studies. The big news? Medications tend to have only temporary and modest benefits, so it makes sense to try something other than a pill. The specifics depend on the type and duration of back pain. For new low back pain (lasting les...
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