MINDFULNESS, not medicine, could be just what the doctor ordered for people suffering from low back pain.
GPs are now less likely to recommend pain medicines, which were previously the go-to treatment for back ache, on the back of recent changes to international guidelines for the management of low back pain (LBP).
Family doctors might suggest non-medicinal approaches including yoga, mindfulness and various physiotherapy and psychological therapies.
That's according to a University of Sydney report looking into the current approach and changes to diagnosis and management of LBP.
Low back pain is the leading cause of disability worldwide and is the second most common reason for seeking care from a family doctor. In Australia, it is the number one cause of early retirement and income poverty.
"Until now, the recommended approach to help LBP in general practice was to prescribe simple pain medicines such as paracetamol or anti-inflammatories," said lead author Adrian Traeger from the Musculoskeletal Health Group at the university's School of Public Health.
"These new guidelines suggest avoiding pain medicines initially and discouraging other invasive treatments such as injections and surgery.
"The recent changes to these guidelines are important and represent a substantial change in thinking on how best to manage LBP - the previous recommendations were in place for decades."
Dr Traeger said if a patient has an uncomplicated case of recent-onset LBP, their doctor may now simply provide advice on how to remain active and non-drug methods for pain relief such as heat and massage, and arrange to see you in two weeks to make sure the pain has settled.
"If your pain started a long time ago, they might suggest treatments such as yoga, exercise or mindfulness," he said.
"Other effective options could include spinal manipulation, acupuncture or multi-disciplinary rehabilitation programs."
But Dr Traeger said that without government support the suggested reforms (taken from guidelines from the UK National Institute for Health and Care Excellence and American College of Physicians) could place more financial strain on those with low back pain.
"It's currently much easier and cheaper to provide a prescription for an opioid pain medicine (which is not a long-term solution to chronic pain and carries a risk of substantial harm) than a course of treatment with a physiotherapist or psychologist," he said.