In making the new recommendations for the treatment of most people the group is bucking what many doctors do and changing its preceding guidelines, which called for drug as first-line therapy.
Dr. Nitin Damle, president of the group's board of regents and a practicing internist, said pills, even over the counter pain relievers and anti-inflammatories, should not be the first choice.
"We must take a look at treatments which can be nonpharmacological first," he said. "That's a change."
The recommendations come as the USA is struggling with an outbreak of opioid addiction that often begins using a straightforward prescription for ailments like back pain. In recent years, several of states have enacted measures directed at curbing prescription painkillers. The issue has also led many physicians around the country to reassess prescribing practices.
The group did not address surgery. Its focus was on treatment that is noninvasive.
The brand new guidelines said that doctors should avoid prescribing opioid painkillers for relief of back pain and suggested that before anti tries -inflammatories or muscle relaxants, they need to try alternative therapies like exercise, acupuncture, massage therapy or yoga. The guidelines also said that steroid injections are not helpful, and neither was acetaminophen, like Tylenol, although other over the counter pain relievers like ibuprofen, naproxen or aspirin could provide some alleviation.
Weinstein, who wasn't a writer of the guidelines, said patients must stay active and wait it out.
"Back pain has an all-natural course that does not require intervention," he said.
Common and annoying
"For extreme back pain, the analogy is to the common cold," Deyo said. "It's very common and very annoying when it occurs. But it will not result in anything serious or important. "
Even those who have persistent back pain — at least 12 weeks, continuing — should begin with nonpharmacological treatments, the guidelines say. If medication is still wanted by patients, they could try over-the-counter drugs like aspirin or ibuprofen.
The results might be misleading — showing what look like abnormalities that really usually are not related to the pain.
As Sommer Kleweno Walley, 43, of Seattle, can attest measures that help patients return to their regular routines can help along the way. She slipped about the stairs and fell down hard, on her back last spring.
"After a few hours I could hardly walk," she said. "I was in actual pain."
She saw a physical therapist, but the pain continued. She expected to get an MRI, at least, and perhaps a drug for pain. You can find more discussions on the topic at health discussion forums.