Most Doctors Ignore Back Pain Guidelines; Ask Patients to Pay for Unnecessary Treatments

Most doctors ignore expert recommendations for the treatment of back pain. And with that, they subject patients to needless tests, surgeries and uncalled exposure to addictive medications, according to a new study.

Dr. Bruce Landon, author of the study and professor of health care policy at Harvard Medical School recommends that the doctors should realize that back pain is not a life-long condition and that patients would usually recover in a couple of months. Therefore, sending them to expensive imaging tests such as CT scans and MRIs, and referring them to specialists are unnecessary.

The researchers evaluated data from periods, 1999-2000 and 2009-2010. They found that the use of narcotic drugs have increased from 19.3 percent to 29.1 percent and usage of recommended OTC pain relievers deflated from 36.9 percent to 24.5 percent.

It is also found that CT scans or MRI’s increased from 7.2 percent to 11.3 percent, and the referrals to specialists such as orthopedic surgeons have doubled from seven percent to 14 percent and those referrals are believed to contribute to the elevation of MRIs and back surgeries recently.

Finally, the study revealed that referrals to physical therapy are consistent at 20 percent. Physical therapies such as core strength building and stretching, as well as regular exercising such as walking and jogging have been shown to improve back pain, particularly those that lasts for more than a couple of months, than lumbar fusion surgery.

“The most worrisome findings were the rapid rise in narcotic prescriptions. In 2008, almost 15,000 people have died from narcotic prescription overdoses,” Landon wrote in the report. Narcotics are believed to have not contributed in improving back pain and can lead to addiction.

Landon believes for the vast majority of patients with back pain, primary care physicians should be taking the lead on managing back pain. Part of the reason for referrals is because patients insist to see specialists and to get high-tech screenings and pain killers.

“For the majority of cases, these things are not necessary, since the majority of back pain improves with time and minimal treatments,” he concluded.

This study was published in JAMA Internal Medicine.

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