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How to Treat Lower-Back Pain

Why exercise — not opioids — is the best remedy for back pain.

Exercise and Back Pain

Sore back? Don’t reach for a pill — get moving.

That’s the latest prescription from the American College of Physicians (ACP), both for treatment and prevention of lower-back pain for most people. The organization recently released its updated clinical-practice guidelines, which amend the group’s previous advice calling for medication as first-line therapy and counter what many doctors have long recommended.

Lower-back pain is one of the most common reasons for doctor visits; an estimated 80 percent of Americans will suffer back pain at some time.

The new guidelines derive from a peer-reviewed meta-analysis of more than 100 studies, which concluded that “most patients with acute or subacute low-back pain improve over time regardless of treatment.”

The recommendations advise doctors to avoid opioids for back-pain relief — a warning that comes as the country is battling an epidemic of opioid addiction that often stems from seemingly innocent prescriptions.

The study found that nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, aspirin, and muscle relaxants, were effective for short-term pain relief — better than steroid injections or acetaminophen, the active ingredient in Tylenol. Surgical procedures were not evaluated.

Careful exercise — including cardio and strength training — was the best remedy. The ACP also endorses acupuncture, tai chi, yoga, and other alternative forms of movement rehabilitation.

Other recent studies back these findings. A 2017 report states that running strengthens intervertebral discs. Another 2017 ACP study of 320 adults with lower-back pain found that yoga and physical therapy achieved similar benefits — and resulted in reduced use of painkillers.

And in a 2016 review published in JAMA Internal Medicine, an American Medical Association meta-analysis of 23 studies with 30,000-plus participants found that “the current evidence suggests that exercise . . . is effective for preventing lower-back pain.”

This originally appeared as “Exercise: A Revolution in Back Pain” in the November 2017 issue of Experience Life.

is an Experience Life deputy editor.

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