Guidelines for low back pain

May 31,2018

Macquarie Stem Cells has provided this information to educate the public based on peer reviewed, published scientific and medical documents. We don’t aim to encourage consumers to seek out such treatments prior to an assessment by a health professional to determine your suitability for treatment. This is obtained directly from The Conversation based on information by Foster et al. There were no financial sponsors identified for this study. We aim to provide you with an unbiased range of treatments that are available aside from biological therapy, this is discussed in ‘supporting information>other-options’  page on our website

The guidelines on low back pain are clear: drugs and surgery should be the last resort.(The conversation, 2018)

“Low back pain is the leading cause of disability worldwide and is becoming more common as our population ages. Most people who have an episode of low back pain recover within six weeks, but two-thirds still have pain after three months. By 12 months, pain may linger but is usually less intense”.  (The conversation, 2018)

“A series on low back pain by the global medical journal The Lancet outlined that most sufferers aren’t getting the most effective treatment. Many health professionals seem to favour less effective treatments such as rest, opioids, spinal injections and surgery.  The articles state that recommended first-line treatments – such as advice to stay active and to exercise – are often overlooked.”  (Foster et al., 2018),(The conversation, 2018)

Evidence based approaches

Acute Injury.

  1. Stay active; patient education is key.
  2. Spinal manipulation; massage; acupuncture
    if the above 2 fail,
  3. Non-steroidal anti-inflammatory drugs

Chronic Back Pain.

  1. Stay active; patient education; exercise therapy; cognitive behavioural therapy are great first line options.
  2. Spinal manipulation; massage; acupuncture; yoga; mindfulness based stress reduction; interdisciplinary rehabilitation
    if the above 2 fail,
  3. Non-steroidal anti-inflammatory drugs; selective norepinephrine reuptake inhibitors; surgery


Exercise and psychological therapy

“The guidelines are based on many studies that have shown the benefits of exercise and psychological therapies. For instance, a 2006 study compared pain levels across two groups of physically active people with chronic low back pain.

Participants who followed a four-week program using Pilates exercise equipment reported a more significant reduction in pain and disability than those in a control group who received usual care (consultations with a health care professional as needed). The benefit for the exercise group was maintained over a 12-month period.

Another, 2011 trial explored the benefits of Tai Chi for those with persistent low back pain. Participants who completed a ten-week course of Tai Chi sessions had less bothersome back symptoms, pain intensity and self‐reported disability, compared with a control group who continued with their normal medical care, fitness or health regimen.

Chronic pain is linked with chemical and structural changes at all levels of the nervous system. These include the level of neurotransmitter changes that alter pain modulation, and sensitisation of the nerves involved in transmitting pain signals. Incoming pain signals can be modified by our response to persistent pain.” (The conversation, 2018)

Manual therapy

“In Australia, physiotherapists, chiropractors and osteopaths use manual and physical therapy to treat lower back pain. The treatments often include some form of spinal manipulation and massage, as well as advice to stay active and do exercises. This is consistent with The Lancet’s recommendations, also based on evidence from studies.

A 2013 trial of people with acute low back pain compared the effects of spinal manipulation with those of the non-steroidal anti-inflammatory drug diclofenac (Voltaren) and placebo on their pain. Spinal manipulation was found to be significantly better than diclofenac and clinically superior to placebo in reducing disability, pain and the need for rescue medication. It was also found to improve quality of life.

Similar results came from another study of 192 people with low back pain that lasted around two to six weeks. Participants were randomly allocated to one of three groups: chiropractic manipulation with a placebo medication; muscle relaxants with sham manipulation; or placebo medicine with sham manipulation. All subjects improved over time, but the chiropractic group responded significantly better, with a bigger decrease in pain scores, than the control group.” (The conversation, 2018)

Take away message:
Stick to your exercises and activities, this is an rehabilitation process. It is not a one stop solution, you alone are the key for personal development.


REF:The Conversation. (2018). The guidelines on low back pain are clear: drugs and surgery should be the last resort. [online] Available at: https://theconversation.com/the-guidelines-on-low-back-pain-are-clear-drugs-and-surgery-should-be-the-last-resort-94746?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20May%2017%202018%20-%20102018958&utm_content=Latest%20from%20The%20Conversation%20for%20May%2017%202018%20-%20102018958+CID_c3f734692127626db374fa408ebdf6dd&utm_source=campaign_monitor&utm_term=The%20guidelines%20on%20low%20back%20pain%20are%20clear%20drugs%20and%20surgery%20should%20be%20the%20last%20resort [Accessed 20 May 2018].

TAGS: Low back pain, Macquarie Stem Cells, Dr. Ralph Bright, treatment options for back pain, surgery for back pain, exercise back pain.


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