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Non-drug therapies should be first line treatment for low back pain, US guidance says

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j840 (Published 15 February 2017) Cite this as: BMJ 2017;356:j840
  1. Michael McCarthy
  1. Seattle

New guidelines from the American College of Physicians recommend that physicians avoid prescribing drugs, particularly opioids, to treat acute and subacute low back pain and should instead emphasize non-pharmacologic therapies, such as superficial heat, massage, and physical therapy.

“Clinicians should reassure patients that acute or subacute low back pain usually improves over time, regardless of treatment. Thus, clinicians should avoid prescribing costly and potentially harmful treatments for these patients, especially narcotics,” the guidelines said.

If clinicians decide to use a pharmacologic agent, non-steroidal anti-inflammatory drugs or skeletal muscle relaxants should be used, …

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