URL of this page: https://medlineplus.gov/podcast/transcript041017.html

To Your Health: NLM Update Transcript

Pain in the low back: 04/10/2017

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health - a consumer health oriented podcast from NLM - that helps you use MedlinePlus to follow up on weekly topics.

Low back pain initially should be addressed by non-invasive therapies rather than medications, suggests new clinical guidelines from the American College of Physicians - recently published (and accompanied by an editorial) within the Annals of Internal Medicine.

The editorial suggests the new guidelines address a problem that routinely has occurred in the treatment of lower back pain. The editorial's author writes (and we quote): 'low back pain is common, and its management may be a good example of low-value health care — expensive tests and therapies that deliver limited benefits in terms of reduced pain and increased function' (end of quote).

Instead, the new guidelines suggest initial therapy for most adults with low back pain should include heat, massage, acupuncture, or spinal manipulation. The guidelines suggest NSAIDs (or nonsteroid anti-inflammatories) should be used only if these approaches fail. Over-the-counter NSAIDs that include aspirin are available across the U.S.

When low back pain persists for more than three months, the new guidelines suggest the use of exercise, rehabilitation, acupuncture, stress reduction, tai chi, yoga, and relaxation techniques in lieu of drug therapies.

The American College of Physicians' new guidelines are based on a review of research about noninvasive, non-drug, and drug therapy of low back pain in adults published between 2008 and 2016. The guidelines were published after a peer review and public comment period.

The new guidelines' overall importance is they place new emphases on less expensive, simpler, and less clinically invasive techniques, notes the editorial's author. Steve Atlas M.D., Massachusetts General Hospital, writes (and we quote): 'these updated reviews and recommendations do not focus on diagnostic tests, such as magnetic resonance imaging, and invasive therapies, such as injections and surgery, which are major drivers of health care spending for low back pain' (end of quote).

To put this another way, the guidelines suggest that low back pain may be one area where less is more: an array of clinical tests and medicines may not be as effective than supervised non-clinical approaches for men and women who experienced persistent discomfort for less than six months.

Meanwhile, the National Institute of Neurological Disorders and Stroke (within NIH) provides a helpful introduction to low back pain within the 'start here' section of MedlinePlus.gov's back pain health topic page.

The American Academy of Family Physicians adds helpful information about low back pain management also within the 'start here' section of MedlinePlus.gov's back pain health topic page.

The Office of Disease Prevention and Health Promotion (part of the U.S. Department of Health and Human Services) provides information about preventing back pain within the 'prevention and risk factors' section of MedlinePlus.gov's back pain health topic page.

MedlinePlus.gov's back pain health topic page additionally provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. Links to relevant clinical trials that may be occurring in your area are available within the 'clinical trials' section. You can sign up to receive updates about back pain as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's back pain health topic page, please type 'back pain' in the search box on MedlinePlus.gov's home page, then, click on 'back pain (National Library of Medicine).' MedlinePlus.gov additionally has health topic pages on back injuries and pain.

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you! Please join us here next week and here's to your health!