American College of Physicians (ACOP) New Guidelines for Treating Low Back Pain

So today my lead preceptor was super exited right from the get-go. A fresh off the press study by the American College of Physicians (ACOP) daringly suggested what their occupational health clinic had been practicing for >15 years: manage low back pain alternatively before attempting opioids & save surgery as the absolute last option. Not the first. This is crucial for several reasons. (1) It has been estimated that over 80% of Americans will experience low back pain at some point in their lifetime, affecting some 250 MILLION AMERICANS. (2) Opioids for decades have been the “magic pill” and that’s absolutely not the case. Yes opioids reduce pain. That’s pharmacologically how they work. However, and most importantly, they do nothing (zilch, zero, nada) to address the fundamental problem that’s causing the pain, and there in lies the problem. You’re putting a patch over problem while you cross your fingers that your body heals itself. For most minor injuries that works, but those patients should not be on opioids in the first place! While more serious and resilient injuries your body is simply overwhelmed and ill equipped to repair itself. That’s what I love about this article and our clinic. They both understand what so few treatment centers around the nation do. Your body can and will heal itself if provided the right incentives and all it takes is the right approach: A competent physician both knowledgable and willing to examine every aspect of the patient from the exact mechanism of injury to their posture in the exam room to even their diet. Appreciating the finer details in not only the patient’s X-rays but more importantly tissues texture changes only appreciated by the physician physically laying hands on the patient. Then combining everything together into a multidimensional treatment plan involving a team of doctors and specialists, physical therapists, the patient themselves and their families. Simply put, if your doctor’s first response to your pain is opioids or a scalpel, you’re in the wrong place. Bare in mind there are instances where surgery is the best option. If a patients blows a disc so bad they can’t walk their going to a neurosurgeon. Thankfully the majority of those 250+ million Americans won’t require those referral forms and far better options besides drugs and sterile knives now exist. 😉

ACOP Article: http://annals.org/aim/article/2603231/noninvasive-treatments-acute-subacute-chronic-low-back-pain

NYTimes Article on the Topic: https://www.nytimes.com/2017/02/13/health/lower-back-pain-surgery-guidelines.html

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