In a remarkable new set of guidelines, the
prestigious American College of Physicians has recommended that doctors avoid
opiods or any kind of medications for lower back pain as a first option, a
departure from previous guidelines.
Instead, the guidelines suggest alternatives: yoga,
acupuncture, massage therapy and cognitive behavior therapy, among others.
Lower back pain is incredibly common. It is in the
top ten reasons why patients visit their doctors. Yet no is quite sure what
causes it. Besides structural reasons, it is associated with smoking, obesity
depression and anxiety. It can also be more complicated than that. “Our best
understanding of low back pain is that it is a biopsychosocial condition—meaning
that structural or anatomic causes play some role, but psychological and social
factors also play a big role,” says Roger Chou, a professor at Oregon Health
and Science University.
The report recommends over-the-counter medications
only if the patient requests it. Opiods, now commonly prescribed, are
discouraged as they have a high risk for addiction and accidental overdose. Dr.
Morton Tavel, a clinical professor of medicine at the Indiana School of
Medicine, recommends avoiding opiates entirely, as they don’t speed up recovery
anyway.
This is not news to Nancy Servine of Moline,
Illinois. She is seventy-six years old and uses her yoga practise to prevent
pain. “The stretches like this are like you would get in therapy,” she says.
“So my doctor says keep doing what you’re doing.”
Her instructor, Tricia Fuelling says that while it
helps prevent pain, it also helps treat it. “You don’t get groggy side effects
from yoga, you don’t have nausea or any of those, you can drive after doing
yoga, where you can’t necessarily do that after taking medication.”
Mohan Ashtakala is the author of "The Yoga Zapper-A Novel," published by Books We Love Ltd.
