Forget the drugs, the answer to back pain may be Tai chi, massage

The answer to lower back pain may lie not in prescription drugs, but in Tai chi, heat therapy or massage, according to health guidelines released Tuesday.

New guidelines from the American College of Physicians (ACP) detail which treatments may help with lower back pain, and make it clear that physicians should suggest prescription drugs as a last resort.

One in four U.S. adults report having lower back pain, which typically goes away in a few days or weeks without treatment, according to the guidelines. The guidelines published in the Annals of Internal Medicine, mark a change from previous medication-first recommendations for treating lower back pain.

"Physicians should reassure their patients that acute and subacute low back pain usually improves over time regardless of treatment," said Nitin S. Damle, MD and president ACP said in a statement. "Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients."

According to the guidelines, people typically suffer from acute back pain, which lasts less than 4 weeks, subacute back pain, which lasts four to 12 weeks or chronic back pain, which lasts more than four months.

For those who are experiencing acute or subacute back pain, the answer to relief can often be found in heat therapy, spinal manipulation, massage, exercise, and yoga or Tai chi, according to the guidelines.

And the same goes for those experiencing chronic back pain.

"For the treatment of chronic low back pain, physicians should select therapies that have the fewest harms and costs, since there were no clear comparative advantages for most treatments compared to one another," Damle said in the statement. "Physicians should remind their patients that any of the recommended physical therapies should be administered by providers with appropriate training."

For those with chronic back pain who find non-drug therapy unsuccessful, physicians should suggest ibuprofen or naproxen and only look to opioids as a last-case scenario, according to the guidelines.

The guidelines are based on studies related the use of medications and other other non-surgical methods of treating lower back pain. According to ACP, surgery is rarely needed for patients experiencing lower back pain.

Here's a look at some of the recommendations for those experiencing lower back back pain lasting less than 12 weeks:

• According to ACP, studies have shown that heat therapy can offer some relief from lower back pain. 
• Massage
• Acupuncture: a medical professional places tiny needles in the skin at certain points on the body
• Spinal manipulation by a medical professional 

Those with chronic lower back pain should try the following:

•  Exercise
• Acupuncture
• Mindfulness-based stress reduction
• Yoga
• Tai chi: a martial art that includes slow, calming movements
• Low-level laser therapy, which uses a low-power laser that can heal muscles.

Here's the full list. 

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