Seeking Options in CAM for Low Back Pain

Seeking Options in CAM

"Low-back pain is one of our society's most common, burdensome health problems," says Josephine P. Briggs, M.D., Director of NCCAM. "The currently available treatments have limitations. Many patients turn to CAM with the hope of decreasing pain, improving function and quality-of-life, preventing recurrence and chronicity, or avoiding side effects of other treatments."

According to the 2007 National Health Interview Survey, back pain is the most common condition for which American adults use CAM. Data suggest that the CAM therapies most frequently used for LBP are chiropractic/manipulation, massage, and acupuncture. Other CAM approaches include yoga, herbal and other dietary supplements, devices, and lifestyle products.

Evaluating Treatment Options

Identifying optimal treatment approaches for LBP can be difficult for both patients and clinicians. A thorough patient assessment is the first step for a clinician who may be considering recommending CAM therapies. Clinical practice guidelines stress the importance of ruling out serious underlying conditions and evaluating a patient's psychosocial factors and emotional distress when doing an assessment of LBP.

Among recent recommendations on LBP are joint clinical guidelines from the American College of Physicians and the American Pain Society (ACP/APS). Released in 2007, the statement's seven major recommendations to clinicians include:

• Conducting a focused history and physical examination to help place patients into one of three categories: nonspecific LBP, back pain potentially associated with radiculopathy or spinal stenosis, or back pain potentially from another specific spinal cause


• Providing patients with evidence-based information on the expected course and on effective self-care options, and advising them to remain active


• Considering use of medications with proven benefits (first-line options are acetaminophen or NSAIDs)


• Considering nonpharmacologic therapy that has proven benefits for patients whose LBP does not improve with self-care alone.

There is a lot more information to follow! You can either stay tuned for future posts or go directly to naturally-holistic.net to read the entire article.

See NIH May, 2009 newsletter for original article