First choice for low back pain is non-drug treatment

The most recent guidelines for the non-invasive treatment of lower back pain from the American College of Physicians published in the February 14, 2017 Annals of Internal Medicine recommend non-drug treatment as a front line approach for acute, sub-acute and chronic lower back pain. Treatment recommendations include superficial heat, massage, acupuncture, spinal manipulation, exercise, and cognitive behavioral therapy to name a few.  They further recommend that pain medication should only be considered in patients who have failed the non-drug treatments and only if the potential benefits outweigh the risks. This should include a discussion with the patient the known risks and realistic benefits of pain medication.