Back Pain News: Tides are Turning

Studies show “Alternatives” may truly be the intelligent 1st choice for back pain, arthritis and other chronic pain

Bad news for drug merchants covering up back pain; really good news for those connecting body with mind, and mind with body (and the people needing their help).

From NIH to NPR to NBC, on top of the recent slams against opioid drugs for chronic pain from the Department of Health and Human Services¹ the media is reporting on new studies showing:

• Tylenol works no better than a placebo for arthritis² and offers virtually no benefit, according to a large study that follows on the heels of last year’s study blasting the drug acetaminophen (paracetamol) as ineffective for low back pain as well³

On the other hand…

• Mindful meditation and yoga (aka MBSR, or Mindfulness-Based Stress Reduction) improves function and reduces pain better than usual medical care. Improvements held 6 and 12 months after the start of an 8 week program⁴
• Cognitive-behavioral therapy (aka CBT) also improved function and reduced pain better than usual medical care. And here as well, after an 8-week program participants were better 6 and 12 months later⁵

So I am pleased to see an NIH director say in this March 22 Press Release:
“The results from this research affirm that non-drug/non-opioid therapies, such as meditation, can help manage chronic low-back pain.”  – Josephine Briggs, M.D., director of National Institute of Health(NIH)/ National Center for Complementary and Integrative Health (NCCIH)

Briggs also says, “It is vital that we identify effective nonpharmacologic treatment options for 25 million people who suffer from daily pain, in the United States.”

Why I’m Excited: The StrongPosture® protocols combined with passive therapies such as chiropractic for joints and massage for muscles are a “Cognitive Body Therapy,” combining the benefits of cognitive behavior therapy (CBT) with the demonstrated bio-mechanical benefits of what was previously called “alternative therapy.”

Coincidentally, my most recent blog post was Connecting Biofeedback, Cognitive Behavior Therapy and StrongPosture® (this was before the CBT and MBSR studies published)

Our goal is to retrain Body AND Mind to subjective and objective accuracy. Daily StrongPosture® exercises synergize with chiropractic manipulation of the spine and extremities as well as muscle therapy with posture exercise tracks for Balance, Alignment and Motion. Combining attentional focus with motor control training helps provide people ongoing skills to help them manage their pain, and along with manipulation to restore joint motion and massage to release soft tissue restrictions helps progressively increase muscle and joint function.

CITED SOURCES

1 The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain, Evidence Report/Technology Assessment Number 218  Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services, Roger Chou, M.D., FACP  Rick Deyo, M.D., M.P.H. Beth Devine, Pharm.D., Ph.D., M.B.A. Ryan Hansen, Pharm.D., Ph.D. Sean Sullivan, Ph.D.  Jeffrey G. Jarvik, M.D., M.P.H. Ian Blazina, M.P.H.  Tracy Dana, M.L.S. Christina Bougatsos, M.P.H.  Judy Turner, Ph.D.  AHRQ Publication No. 14-E005-EF September 2014. Retrieved from http://www.effectivehealthcare.ahrq.gov/ehc/products/557/1971/chronic-pain-opioid-treatment-report-140929.pdf

2 da Costa, B. R., Reichenbach, S., Keller, N., Nartey, L., Wandel, S., Jüni, P., & Trelle, S. (2016). Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: A network meta-analysis. Lancet. doi:10.1016/S0140-6736(16)30002-2. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30002-2/abstract

3 Williams, C, Maher, CG, Latimer, J, McLachlan, AJ, Hancock, MJ, O Day, R, Lin, C. (25 July 2014). Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. The Lancet. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60805-9/abstract

4 Cherkin, D. C., Sherman, K. J., Balderson, B. H., Cook, A. J., Anderson, M. L., Hawkes, R. J., . . . Turner, J. A. (2016). Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: A randomized clinical trial. JAMA: The Journal of the American Medical Association, 315(12), 1240-1249. doi:10.1001/jama.2016.2323. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=2504811

5 Study Finds Mindfulness Meditation Offers Relief for Low-Back Pain, National Institutes of Health, National Center for Complementary and Integrative Health (NCCIH), https://nccih.nih.gov/news/press/03222016