Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain
Authors: Donald M. Marcus
Journal: Annals of Internal Medicine (2017)

Letters5 December 2017Noninvasive Treatments for Acute, Subacute, and Chronic Low Back PainDonald M. Marcus, MDDonald M. Marcus, MDBaylor College of Medicine, Houston, Texas (D.M.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0469 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Qaseem and colleagues' guideline (1) appropriately emphasizes the importance of nonpharmacologic therapies for back pain, which are underutilized; however, their recommendation of many therapies supported by low to moderate evidence is confusing. Moreover, I disagree with the claim of moderate-quality evidence for acupuncture. Placebos are effective for relief of pain, and many sham procedures have been used as controls for traditional acupuncture. The preponderance of evidence from high-quality, controlled trials shows that there is no clinically relevant difference between sham and traditional acupuncture for relief of knee osteoarthritis or back pain (2). The guideline is partly based ...References1. Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians.. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166:514-30. [PMID: 28192789]. doi:10.7326/M16-2367 LinkGoogle Scholar2. Marcus DM. Is acupuncture for pain a placebo treatment? An examination of the evidence. The Rheumatologist. 2010;4:28-35. Google Scholar3. Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, et al. Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline. Ann Intern Med. 2017;166:493-505. [PMID: 28192793]. doi:10.7326/M16-2459 LinkGoogle Scholar4. Greenfield S. Clinical practice guidelines: expanded use and misuse [Editorial]. JAMA. 2017;317:594-5. [PMID: 28196236] doi:10.1001/jama.2016.19969 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Baylor College of Medicine, Houston, Texas (D.M.M.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0469. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNoninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Timothy J. Wilt , Robert M. McLean , Mary Ann Forciea , and Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain Mark Collen Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain Ivan Vucina Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain Donald R. Murphy , Michael J. Schneider , Christopher G. Bise , and Brian Justice Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain Lisa H. Le and Robert G. Badgett Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain Jeremy D. Whyman and Rosanne M. Leipzig Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain Sandeep Vijan , Scott Manaker , and Amir Qaseem Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain Alain Braillon Metrics 5 December 2017Volume 167, Issue 11Page: 832KeywordsAcupunctureConflicts of interestDisclosureHealth care providersKneesLower back painOsteoarthritisSystematic reviews ePublished: 5 December 2017 Issue Published: 5 December 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...