Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain
Authors: Alain Braillon
Journal: Annals of Internal Medicine (2017)

Letters5 December 2017Noninvasive Treatments for Acute, Subacute, and Chronic Low Back PainAlain Braillon, MD, PhDAlain Braillon, MD, PhDUniversity Hospital, Amiens, France (A.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0468 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:That Qaseem and colleagues' (1) guideline on noninvasive treatments for low back pain recommends “complementary and alternative medicine therapies (spinal manipulation, acupuncture, and massage)” while mentioning the “low-quality evidence” of these interventions deserves comment.First, the correct term is complementary and alternative practices; “medicine” should be based on evidence. Adding “therapies” to practices that enduringly fail to show evidence of relevant effects creates an oxymoron (2). For low back pain, end points are decreased pharmacologic treatment, increased odds of being able to work, and improved functional limitations or quality of life.Second, this guideline ignores several old, ...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. Braillon A. Placebo and chronic low back pain: too much in way of expectations, too little in terms of data. Pain. 2017;158:535-6. [PMID: 28187104] doi:10.1097/j.pain.0000000000000794 CrossrefMedlineGoogle Scholar3. Cherkin DC, Sherman KJ, Balderson BH, Cook AJ, Anderson ML, Hawkes RJ, et al. 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. 2016;315:1240-9. [PMID: 27002445] doi:10.1001/jama.2016.2323 CrossrefMedlineGoogle Scholar4. Lamb SE, Hansen Z, Lall R, Castelnuovo E, Withers EJ, Nichols V, et al; Back Skills Training Trial investigators.. Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. Lancet. 2010;375:916-23. [PMID: 20189241] doi:10.1016/S0140-6736(09)62164-4 CrossrefMedlineGoogle Scholar5. Cherkin DC, Anderson ML, Sherman KJ, Balderson BH, Cook AJ, Hansen KE, et al. Two-year follow-up of a randomized clinical trial of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care for chronic low back pain [Letter]. JAMA. 2017;317:642-4. [PMID: 28196244] doi:10.1001/jama.2016.17814 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University Hospital, Amiens, France (A.B.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0468. 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 Donald M. Marcus 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 Metrics 5 December 2017Volume 167, Issue 11Page: 831-832KeywordsAcupunctureClinical trialsComplementary and alternative medicineConflicts of interestDisclosureHealth careLower back painQuality of lifeTreatment guidelines ePublished: 5 December 2017 Issue Published: 5 December 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...