New low back pain treatment guidelines from the American College of Physicians (ACP) were published on February 13 in the Annals of Internal Medicine. Based on a review of the evidence, the ACP concluded that pharmacological interventions for low back pain offered fewer benefits and greater risks than nonpharmacological therapy.
The ACP now strongly recommends that low back pain be treated with alternative therapies including massage, acupuncture, spinal manipulation, exercise, multidisciplinary rehabilitation, mindfulness-based stress reduction, tai chi, yoga, biofeedback, low-level laser therapy, or cognitive-behavioral therapy. It further recommend that only if these treatments fail should pharmacological treatment be considered and that the preferred option is nonsteroidal anti-inflammatory drugs. The ACP advised that opioids should be used only as a last resort and only after weighing whether the potential benefits outweigh the risks.
These recommendations are long overdue. As I describe in my book, The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free, too many pain patients have been harmed by poorly vetted medications while safer, more effective treatments have been ignored. However, these new guidelines won’t help most pain patients because health insurers refuse to pay for the recommended treatments and few patients can afford to pay for them out of pocket. Insurers need to be required to pay for these therapies. I’ve developed a legislative proposal, the Pain Treatment Parity Act, to address this issue and I’m currently lobbying for its adoption.
The Pain Treatment Parity Act would require health insurance companies to provide coverage for all pain treatments that have been proven effective as readily as they pay for pharmaceutical treatments. It would also require that health care providers offering these treatments receive adequate reimbursement in order to ensure that these treatments are widely available. Please sign my petition to the President and Congress to pass the Pain Treatment Parity Act here: change.org.