PHILADELPHIA, PA – Last week, the American College of Physicians (ACP) published new recommendations for the management of nonradicular low back pain in the Annals of Internal Medicine advocating nonpharmacologic treatment since “most patients… improve over time regardless of treatment.” It went on to say, “Look, we’ll be blunt: use anything you want, just not narcotics, okay?”
Nonpharmacologic therapies include superficial heat, massage, acupuncture, spinal manipulation, mindfulness-based stress reduction, tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, and cognitive behavior therapy.
But that’s not all.
The list of nonpharmacologic treatment continued: video games, Sudoku, juggling, tightrope walking, bungee jumping, yodeling, archery, backgammon, rodeo, using your imagination, story time, and tickling matches. The recommendations then went on to say that if pharmacologic therapy is desired, then the best choices would be NSAIDs or muscle relaxants. That’s it. No opioids. Hallelujah!
“Look, let me put it this way,” explained ACP spokesperson Bill Sullivan. “Use anything, anything, ANYTHING, I don’t care if you make it up, whatever, just don’t use narcotics. DON’T. Those things are the WORST. And definitely no Dilaudid.”