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Health Check: Treating low back pain

New guidelines from the American College of Physicians focus on nonpharmacological treatments for back pain first. (WJAR)

A new approach to treating low back pain.

These are actually new guidelines from the American College of Physicians that focus on nonpharmacological treatments first.

"The patients have really needed and wanted it," said Dr. Alexios Carayannopoulos, director of the Comprehensive Spine Center at Rhode Island Hospital. "They're very responsive to it."

"The guidelines essentially say that things that had been in place for a long time--injections, surgeries, interventional approaches, really should be tried after most conservative things," he said, pointing out his center has been practicing this for some time.

Things like physical therapy.

"I strongly believe in daily movement and trying to find an exercise for the patients that they enjoy doing," said Jennifer Reynolds, doctor of physical therapy at the Spine Center.

"I think that physical therapy is absolutely important," echoed 70-year-old Richard Casten from Portsmouth .

We talked to him by telephone from Colorado where he has spent the last few months skiing. A huge feat given where he was when he came to the spine center last fall with severe spinal stenosis.

"I wasn't sure if I'd be able to ski this winter or any winter the way I felt. I could barely move," said Casten.

"The most common procedure for spinal stenosis, which is the only true fix for the problem, is to take off part of this bone in here which is called lamina," said Carayannopoulos.

Instead of surgery, Casten had one injection, to help alleviate the pain. Then it was on to physical therapy.

"I just responded really, really well with their guidance,” Casten said of his physical therapy he underwent at Vanderbilt Rehabilitation Center in Newport, which is part of Lifespan.

And now he says he skis most days. This spine center also offers acupuncture and other alternative therapies as first line treatments. Catherine DeFarias, a nurse here is now a trained yoga instructor. It's all by design.

"It really helps open up the spine," said DeFarias. "We're going to be offering classes possibly something this fall and it will be free to our patients."

These new recommendations come as the U.S. is struggling with an opioid epidemic. The addiction often beginning with one simple prescription.


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