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02/21/2017

Opioid Crisis in America: Extensive Medical Study Says Consider Manipulation

ANJC News Release on ACP Guidelines

 BRANCHBURG – The American College of Physicians (ACP) has just issued a new guideline for physicians to follow recommending non-drug treatments, including spinal manipulation, as the first step in treating patients with low back pain.

Chiropractors are the largest physician group that renders safe, effective spinal manipulation. The ACP also listed massage, acupuncture, tai chi and yoga. The ACP further says, “Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients.”

The evidence-based clinical practice guidelines were published this week in the Annals of Internal Medicine.

“For the treatment of chronic low back pain, physicians should select therapies that have the fewest harms and costs, since there were no clear comparative advantages for most treatments compared to one another,” said ACP President Nitin S. Damle, “Physicians should remind their patients that any of the recommended physical therapies should be administered by providers with appropriate training.”

ACP is a national organization of internists, the largest medical-specialty organization, and second-largest physician group in the United States. Our 148,000 members include internists, internal medicine subspecialists, medical students, residents, and fellows.

For patients with chronic low back pain who have had an inadequate response to non-drug therapy, ACP recommends that physicians and patients consider treatment with NSAIDs as first line therapy; or tramadol or duloxetine as second line therapy. Physicians should only consider opioids as an option in patients who have failed the aforementioned treatments and only if the potential benefits outweigh the risks for individual patients and after a discussion of known risks and realistic benefits with patients.

“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.

“This comes as no surprise to the millions of patients that seek Chiropractic care each and every year, said Dr. Steven Clarke, President of the Association of New Jersey Chiropractors.  “Our doctors have always been highly trained, compassionate and effective with the care that they provide. With heightened attention to the opioid crisis, pain patients will increasingly seek chiropractic care as one of their first treatments for back and other painful conditions.”

The ACP says low back pain is one of the most common reasons for all physician visits in the U.S. Most Americans have experienced low back pain. Approximately one quarter of U.S. adults reported having low back pain lasting at least one day in the past three months.           

ACP’s clinical practice guidelines are developed through a rigorous process based on an extensive review of the highest quality evidence available, including randomized control trials and data from observational studies. ACP also identifies gaps in evidence and direction for future research through its guidelines development process.

For more information on the new guideline, click here.