The American College of Physicians (ACP) recently made a significant update to its guidelines concerning low back pain. ACP now suggests alternative therapies that are non-pharmaceutical first such as heat therapy, massage, acupuncture or spinal manipulation for low back pain.

“This marks another step of a philosophical change within the allopathic profession to not utilize pharmaceutical agents as the first line treatment in the management of pain,” said Chris Arick, DC, MS, assistant dean of chiropractic medicine at National University of Health Sciences. “It is also an acknowledgement, at least partially, to focus on the body’s power to perceive pain and to promote a repair mechanism.”

These changes may have a large impact on the kind of care many Americans receive for back pain, which is particularly common. Approximately one quarter of adults reported having low back pain lasting at least 1 day in the past 3 months, according to ACP.

Although these guidelines are an improvement in patient care in regards to the medical community, patients of chiropractic physicians should always feel comfortable using their doctor as a resource for clarification of their pain, Dr. Arick said.

Previously, the association recommended MDs prescribe medicines, including opioids first. But with widespread opioid addiction in the United States today, MDs have taken notice. In recent years they have been reassessing how they prescribe painkillers given their unintended side effects.

“In regards to pain, medications generally do not improve the biochemical repair process or the environment in the body to do so,” Dr. Arick said.

The association now recommends staying active with various kinds of exercise as well, including yoga, pilates and tai chi. These guidelines which suggest using medication as a last resort for lower back pain along with making certain lifestyle changes has been the philosophy for many pain relief treatments offered by NUHS interns.

Back problems are by far the primary reason for appointments with National University’s acupuncturist interns and acupuncturists in general, according to Zhanxiang Wang, PhD, MD(China), LAc, assistant dean of the acupuncture and oriental medicine program at NUHS.

National University interns have also been performing acupuncture for pain relief as part of a clerkship at Cook County’s John H. Stroger, Jr. Hospital since 2012. Due to patient demand, National University interns currently work four shifts per week at the hospital.

“The insertion of thin needles into precise points throughout the body helps clear away blockages of Qi in the body and relieves the pain,” Dr. Wang said. “Disease state like pain arises from a blockage in the flow of the Qi (chi).”

The treatment points for back pain vary depending on the stage and type but it is not uncommon for the acupuncturist to needle points on your hand, foot and head for back pain.

Massage therapy is also a powerful tool, not only in treating back pain, but pain in general.

Jerrilyn Cambron, DC, MPH, PhD, LMT, research professor and chair of the College of Allied Health Sciences at National University, recently co-authored a series of papers published in the journal  Pain Medicine in July 2016.

“With these new ACP guidelines, the mainstream health care community is beginning to change the way they approach pain,” said Dr. Cambron. “Today more massage therapists can be found in medical offices and hospitals because of the significant benefits massage therapy may have for many conditions, particularly pain.”

At the NUHS Whole Health Center clinic in Lombard, patients with back pain go through an indicated history and focused exam to determine the next course of action and the pathophysiological cause of pain before making a diagnosis. This may include further laboratory tests and imaging.

Because NUHS chiropractic medicine students are trained as primary care physicians in addition to musculoskeletal care, they are able to help a wide variety of pain issues.

Other alternative medicine degrees offered at NUHS that focus on least toxic and invasive include naturopathic medicine, oriental medicine and acupuncture along with certification in massage therapy.  As the health care community continues to shift toward less pharmaceutical and less invasive treatments, NUHS students will be well prepared for the growing demand.