Low back pain

The American College of Physicians(ACP) for the first time ever asserts in the 2017 guidelines on the noninvasive management of low back pain that common anti-inflammatory drugs such as aspirin and acetaminophen, are “completely useless” as the first approach to back pain. Even painkillers did not work better than a placebo in reducing the pain intensity in the first 4 weeks of acute low back pain.

The same thing emerges from an analysis of 35 randomized trials that covered over 6,000 people with low back pain who used painkillers and anti-inflammatory drugs  . Conducted by the George Institute for Global Health in Sydney, which revealed that collectively known drugs such as non-steroidal anti-inflammatory drugs, or NSAIDs, offer benefits equal or a slightly superior to placebo.

healthy foodPainkillers are not the answer to acute or chronic low back pain, the researchers warn.
The clinicians and patients should select nonpharmacological treatment like spinal manipulation as a primary treatment approach and only those who do not improve with non-drug therapies should consider analgesics, but always as a secondary treatment.  Remember that the effects of pharmaceutical treatments are small and short-lived with a great potential risk of side-effects.


How risky are NSAIDS?

Regular exercises help keep back pain away and people should choose an activity that they like most and which stimulates cardiovascular circulation.

Always remember the structure of our body, our vitality, the resistance to illness, and the health of all our organs and tissues also depends profoundly on what we eat and drink.

When pain appears, for example in the case of acute low back pain, in usually 40% of the cases it disappears within a couple of weeks, but if it persists then most independent researches who are not funded by pharmaceutical companies or have personal interests recommend chiropractic and vertebral manipulation as the best approach to low back pain.

It is good to know that the new clinical guidelines from the American College of Physicians published in the beginning of 2011 says that routine spinal imaging literally has no value  and should be eliminated from modern back care. They not only found strong evidence that routine imaging for low back pain by using X-Rays or MRI’s is not associated with a clinically meaningful effect on patient outcomes, but also that it often leads to a long and expensive cascade of unnecessary referrals, nonsurgical treatments, interventional pain procedures and useless surgery. (Bauer et al.: Spine 32 oct. 2013)

Recently another large hole has been shot in finding diagnostic answers on imaging scans: The so called visual evidence of spinal stenosis on MRI and CT scans does not have any consistent relationship with pain and symptoms in patients. Spinal stenosis is the most common surgical indication among people older than 65 years of age and just think that often these patients are routed toward surgery on the basis of imaging scans. (Burgstaller JM et al., Spine, 2017; 41(7):E1053-62.).

Ann. Intern. Med. 4 April 2017, Vol.166 No. 7 .514-53.
Bauer et  al.: Spine 32 oct. 2013

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