Acupuncture is recommended for chronic low back pain

New Guidelines Issued For Treatment Of Lower Back Pain

CBS News (2/13, LaPook) reports on its website that the American College of Physicians released new guidelines that says “the first line of therapy” for chronic low back pain “should be non-drug treatments.” The new guidelines recommend “heat wraps, massage, acupuncture and spinal manipulation” for pain lasting less than three months, and recommend treatments such as “stretching and strengthening exercises, tai chi, yoga, acupuncture, and mindfulness techniques” for pain lasting more than three months.

Newsday (NY) (2/13, Ricks) reports, “The new guidelines emphasize that opioid” pain medications “should be considered only as a last resort.”

The New York Times (2/13, A21, Kolata, Subscription Publication) reports that in its recommendations, the ACP “did not address surgery.” Instead, “its focus was on noninvasive treatment.” In addition, imaging “scans... for diagnosis are worse than useless for back pain patients, members of the group said in telephone interviews.” Scan “results can be misleading, showing what look like abnormalities that actually are not related to the pain.” The new guidelines (2/14) were published in the Annals of Internal Medicine.

据美国内科年鉴2017年2月14日发表的腰痛治疗指南，美国医师学会推荐多种非药物治疗为一线疗法，但在各种被推荐的非药物疗法中，针灸是唯一被推荐为治疗急性和慢性腰痛的一线疗法。

该指南对于病史少于三个月的急性腰痛，推荐热敷、按摩、针灸、整脊疗法；对于超过三个月以上的慢性腰痛，推荐伸展和伸展锻炼、太极拳、瑜伽、针灸和心身疗法。而吗啡类止痛药，被列为最后的选择，指南中没提到手术疗法。

有关专家还表示，影像扫描诊断腰痛不仅是没有价值，还会显示与疼痛无关的结构异常，对医患产生误导。显然，美国医界的这个指南是在付出了沉重的“滥用止痛药”代价后推出的，对今后的医疗业和市场都会产生巨大影响，毕竟，腰痛是临床最常见的病症之一。