Experts Say Drugs, X-Rays, Scans And Surgery Are Unnecessary For Back Pain

Modesto Morganelli
Marzo 22, 2018

Professor Buchbinder's paper cited the ongoing opioid addiction crisis in the U.S. as a worst-case scenario if the medication-oriented approach to low back pain wasn't shifted.

The Lancet series highlights the extent to which the condition is mistreated, often against best practice treatment guidelines.

"In terms of burden of low back and neck pain in India - it accounts for nearly 7% of years lived with disability".

It's estimated that at any one time more than 540 million people are affected by activity-limiting low back pain and it's the most common disability in the world.

In the United States, low back pain leads to 2.6 million emergency room visits each year.

"However, in reality, a high proportion of patients worldwide are treated in emergency departments, encouraged to rest and stop work, are commonly referred for scans or surgery or prescribed painkillers including opioids, which are discouraged for treating low back pain", Buchbinder said.

She added: "It is also the case that access to psychological treatments, such as talking therapies, which we know can be beneficial for patients suffering from lower back pain, is patchy across the country".

The series reviewed evidence from high- and low-income countries that suggests that numerous mistakes of high-income countries are already well established in low-income and middle-income countries. In India, studies suggest that bed rest is frequently recommended, and a study in South Africa found that 90% of patients received pain medicine as their only form of treatment, the series has highlighted.

A study a year ago reported low back pain as the leading cause of disability in nearly all high-income countries, as well as in central and eastern Europe, North Africa and the Middle East, and parts of Latin America.

Imaging for low back pain also seems to be highly prevalent in several low-income and middle-income countries, including India.

Low back pain mostly affects working-age adults and a specific cause is rarely pinpointed. "Most people do not need imaging".

"Back pain disability globally has increased by 54 per cent between 1990 and 2015 and its getting worse and its getting worse due to the ageing population as well as the increased size of the population", said Prof Buchbinder.

Episodes are usually short-lasting with no effect, but recurrence is common - about one in three people will have a recurrence within a year of recovering from a previous bout, according to the researchers.

They should not offer acupuncture, traction (stretching the back using weights or machines), or electrotherapy (passing electric current or ultrasound waves through the body), says the National Institute for Health and Care Excellence.

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