Back pain over-treated - experts

Thursday March 22nd, 2018

Too many patients get the wrong care – and are over-treated – for low back pain, experts say today.

Most of the 540 million patients with the problem need advice to keep active and at work, according to writers in The Lancet.

Instead in poor countries they are advised to rest while in wealthy countries such as the USA opioids are widely prescribed and many patients end up in the operating theatre.

One of the experts Professor Nadine Foster, of Keele University, UK, said: "In many countries, painkillers that have limited positive effect are routinely prescribed for low back pain, with very little emphasis on interventions that are evidence based such as exercises.

“As lower-income countries respond to this rapidly rising cause of disability, it is critical that they avoid the waste that these misguided practices entail.”

Fellow writer Professor Jan Hartvigsen, of the University of Southern Denmark, said: "Millions of people across the world are getting the wrong care for low back pain. Protection of the public from unproven or harmful approaches to managing low back pain requires that governments and health-care leaders tackle entrenched and counterproductive reimbursement strategies, vested interests, and financial and professional incentives that maintain the status quo.

"Funders should pay only for high-value care, stop funding ineffective or harmful tests and treatments, and importantly intensify research into prevention, better tests and better treatments."

And Professor Martin Underwood, of the University of Warwick, added: "Our current treatment approaches are failing to reduce the burden of back pain disability; we need to change the way we approach back pain treatment in the UK and help low and middle income countries to avoid developing high cost services of limited effectiveness."

But the Royal College of GPs said that drug treatments could “provide a great deal of relief.”

Chair Professor Helen Stokes-Lampard said: “We know that being active and working is good for our patients’ health, so GPs and our teams will readily advocate lifestyle changes to patients that can help ease their pain and keep them in work, but for some patients, particularly in more serious cases, there is a limit to how realistic a significant amount of exercise is.”

Lancet 22 March 2018

Link: http://www.thelancet.com/series/low-back-pain

Tags: Orthopaedics | Pain Relief | UK News | World Health

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