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New clinical guidelines recommend non-drug therapies for treating lower back pain

New clinical guidelines recommend non-drug therapies for treating lower back pain

Low level laser therapy is one of the recommended treatments included by the American College of Physicians (ACP) in its latest clinical guidelines for chronic lower back pain.

This evidence-based clinical practice guideline for non-invasive treatment of low back pain, published in Annals of Internal Medicine (February 2017), recommends that physicians and patients should treat persistent low back pain with non-drug therapies first.


For people suffering from chronic lower back pain (lasting for more than 12 weeks), ACP advises health practitioners initially refer them to non-drug therapies. Among these therapies ACP included exercise, low level laser therapy, acupuncture, mindfulness-based stress reduction, multidisciplinary rehabilitation, tai chi, yoga, motor control exercise (MCE), progressive relaxation, electromyography biofeedback, operant therapy, cognitive behavioural therapy, and spinal manipulation.

Lower back pain is a common and costly condition in Australia. It’s estimated around 80 per cent of Australians experienced back pain at some point in their lives. One in 10 people experiencing significant disability as a result.  

Low level laser therapy is a non-invasive pain management treatment, using low frequency wavelengths of light to stimulate the body’s anti-inflammatory healing response. It does not create heat and the laser-beam targets the site of pain.

The ACP strongly advises doctors and patients to only use nonsteroidal anti-inflammatory drugs (NSAIDs) or skeletal muscle relaxants as a last resort.

President of ACP, Nitin S. Damle, MD, MS, MACP, said, “Physicians should consider opioids as a last option for treatment and only in patients who have failed other therapies, as they are associated with substantial harms, including the risk of addiction or accidental overdose,” said Dr. Damle.

ACP’s clinical practice guidelines were developed through a rigorous process based on an extensive review of the highest quality evidence available, including randomised control trials and data from observational studies. 

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