The American College of Physicians rolled out new recommendations for treating back pain, advising non-drug options such as Tai chi, yoga, acupuncture, and mindfulness meditation before resorting to prescription or over-the-counter pain medications.

Lower back pain remains one of the most common reasons for doctor visits in the country, according to the new advice published in the Annals of Internal Medicine. These guidelines call for using non-drug treatments first before using OTC painkillers such as ibuprofen, as well as discourage using opioid painkillers due to the danger of addiction or overdose.

Just recently, a national survey from Consumer Reports showed many back pain patients found alternative therapies useful. In the survey of 3,562 adults, nearly 90 percent of people who tried Tai chi or yoga said they helped, while 84 percent said the same of massage. Eighty-three percent also deemed chiropractic useful.

Yoga In Focus

Researchers from the National Center for Complementary and Integrative Health analyzed around 105 randomized controlled trials done in the last 50 years and concluded that non-drug techniques offered reasonable pain relief with or without prescription drugs.

Yoga was found effective against back pain, while tai chi as well as acupuncture helped relieve osteoarthritis. Relaxation too provided relief for those suffering migraine and severe headaches.

Yoga is touted particularly helpful for conditioning, which can enhance one’s flexibility and core strength — two things that often lack in people with chronic pain, according to Dr. Santhosh Thomas of the Cleveland Clinic’s Center for Spine Health, but one should be careful about going straight to a yoga class or a masseuse right away, as doctors can still best provide additional guidance.

Yoga’s popularity in the United States has surged in recent years, and it usually involved a mix of physical movements, controlled breathing, and meditation or relaxation.

Mindfulness Meditation

A study in March 2016 offered evidence that mind-based therapies, namely mindfulness and cognitive-behavioral therapy, may be more effective in treating chronic back pain than usual treatments.

Over 300 participants with chronic low back pain, ages 20 to 70 and whose pain came from unknown causes, were randomly assigned to one of two mind therapies or conventional care for one year. Those who used mindfulness and CBT saw greater improvement in their function than the standard-care group.

Mindfulness-based stress reduction therapy integrates different elements of mindfulness, yoga, as well as meditation, while CBT is a psychotherapeutic method encouraging modifying one’s thoughts and behaviors. Recently, mindful meditation was also linked to benefits for anxiety disorder patients.

According to the guidelines from ACP, any of the non-drug strategies may be done for a week or more. If pain has not let up to allow the patient to perform his or her daily tasks, it is important to inform a doctor, who may in turn recommend an OTC non-steroidal anti-inflammatory drug for the pain as well as inflammation.

It is deemed appropriate to take 800 milligrams of ibuprofen two to three times a day or 500 grams of naproxen twice a day for five to seven days. One may also want to skip acetaminophen (such as Tylenol), which showed low effectiveness for improving function or pain.

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