American College of Physicians: Use Alternative Therapies for Back Pain, Opioids Last Resort

In This Article

American College of Physicians: Use Alternative Therapies for Back Pain, Opioids Last Resort

According to guidelines released this week from the American College of Physicians, patients who suffer from chronic back should first try alternative treatments before turning to opioid painkillers. Preferrable treatments include acupuncture, medication, tai chi, and yoga.

These guidelines, published in the Annals of Internal Medicine, are just the latest among several recent professional recommendations intended to curb the country’s opioid addiction epidemic. The new recommendations are based on reviews of over 150 studies.

Last year, the surgeon general estimated that opioids are now responsible for approximately 78 overdose deaths per day. The new guidelines note that they should be an option only for patients who have not received effected results from other treatments, “and only if the potential benefits outweigh the risks for individual patients and after a discussion of known risks and realistic benefits.”

But unfortunately, health insurance is more likely to cover prescription medication than tai chi or yoga classes. And surgery, although once a popular option, has more recently been found to garner mixed results, or even make pain worse.

Ironically, prescription opioids can also increase a patient’s level of pain. It’s a condition called hyperalgesia, and it causes the patient to become more sensitive to pain in the long run.

The guidelines, released last Monday, made three sets of recommendations:

  • For acute pain (lasting up to 12 weeks) non-medicinal treatments are preferred. The strongest evidence is for the application of heat. There is additional evidence for acupuncture, massage, and spinal manipulation. Medicinally, evidence supports the use of non-steroidal, anti-inflammatory drugs such as aspirin, ibuprofen, and muscle relaxants.
  • Chronic pain (lasting more than 12 weeks) should be treated initially with exercise, multidisciplinary rehabilitation, and acupuncture. There is also evidence for the effectiveness of other practices including biofeedback, cognitive behavioral therapy, tai chi, and yoga.
  • Chronic back pain that does not respond to non-medicinal treatments should be treated with NSAIDS first. Tramadol (an opioid) or duloxetine (an antidepressant) are recommended as a second line of treatment. Other opioids are only indicated as a last resort.

~ G. Nathalee Serrels, M.A., Psychology

Just Believe Recovery White Logo

Just Believe Recovery is a fully licensed, Joint Commission accredited, comprehensive drug and alcohol treatment center located in Jensen Beach, Florida.

Let's Connect

🔒 Your information is safe & secure
  • This field is for validation purposes and should be left unchanged.
Anger, Frustration, and Fear | Just Believe Recovery Center
Behavioral Addictions

Anger, Frustration, and Fear

Feelings of fear and frustration lead people to do things they thought they would not normally do. Acting out in anger can put you in

Read More »
Is Alcoholism Genetic or Hereditary? | Just Believe Recovery

Is Alcoholism Genetic or Hereditary?

Addiction is a chronic, often life-long illness that affects the brain’s reward and pleasure centers, and scientists have long debated over possible genetic and hereditary

Read More »

We Believe Recovery Is Possible For Everyone.

Our dedicated admissions team is standing by to answer any questions you might have.

You don’t have to do this alone. Call today!