The American College of Physicians (ACP) developed a guideline to encourage clinicians and patients to consider the evidence when making decisions regarding the treatment of low back pain. They recommend that physicians and patients treat acute and chronic low back pain with non-drug therapies such as superficial heat, massage, acupuncture, or spinal manipulation. If drug therapy is desired, physicians and patients should consider nonsteroidal anti-inflammatory drugs (NSAIDs) or skeletal muscle relaxants.

Read the full guidelines here.

Physical therapy and chiropractic are both first-line options for the treatment and prevention of low back pain. Early engagement of of these clinicians has been found to help decrease healthcare costs, while also improving long-term outcomes for patients. The one-on-one focus of treatment, along with utilization of evidence-based interventions, can help improve patients’ function in order to get them back to activities that they once enjoyed.

Both chiropractors and physical therapists utilize various approaches to assist patients in their recovery from low back pain. A primary area of focus is to optimize patient function through therapeutic exercise, as well as through education on the nature of back pain and what treatments are currently recommended by guidelines. In addition, PTs and DCs are trained to use spinal manipulation and mobilization, and soft tissue mobilization. Many also are able to provide acupuncture and/or dry needling. Regardless of what treatments are selected, the overall approach of these clinicians is to provide care in an individualized way that puts the patient at the center of treatment.