The information contained in this story is not the opinion of the PIA Western Alliance, its staff or management. We’re not doctors but did find the story interesting.
Low back pain is troublesome. It’s especially bad for really active people and for those who sit a lot. The health publication The Lancet says some 540 million people are affected by low back pain at any given time.
It recently published a series of papers on the subject of lower back pain.
The malady is one of the subjects of a 2017 study called The Global Burden of Disease. It found low back pain to be the leading cause of disability in almost all high-income countries including the United States, central and eastern Europe, North Africa, the Middle East and parts of Latin America.
The study found a total of three million years of productive life is lost each year in the United States because of low back pain. Other countries have the same problem. The United Kingdom lost one million years in a year, Australia saw 300,000 years.
Back pain disability has grown by 50% since 1990. Look for it — the study says — to grow more coming decades as the population increases and as the population of older people grows.
The Lancet article series said the 540 million low back pain sufferers around the world are not getting the best possible treatment. Australia Monash University Professor Rachelle Buchbinder is one of the authors of the papers. She said low back pain is usually treated like this:
• Treatment starts in emergency rooms
• Doctors there prescribe rest and stopping work
• Patients are referred to other doctors for scans or surgery
• Patients are often given pain killers including opioids
All of these — she says — are discouraged for treating low back pain. Buchbinder said the best treatment is education and the patient needs to remain active and working and not sedentary.
“The majority of cases of low back pain respond to simple physical and psychological therapies that keep people active and enable them to stay at work. Often, however, it is more aggressive treatments of dubious benefit that are promoted and reimbursed,” she said.
In the U.S. each year 2.6 million people visit emergency rooms with low back pain. About 60% of them end up with an opioid prescription. Only half of the people complaining of chronic low back pain have been told to exercise.
It’s just as bad — Buchbinder said — in India and South Africa. In India bed rest is the frequent treatment and in South Africa pain meds are prescribed to 90% of patients. It is their only form of treatment.
U.K. Professor Nadie Foster of Keele University is also one of the authors of the papers. She 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.”
It doesn’t take a study or a series of papers to tell you who is most affected. It’s working age adults. Most episodes don’t last long and have little or no consequence. Recurring episodes are common with one in three having a recurrence within a year.
Another author is Professor Jan Hartvigsen of the University of Southern Denmark. Hartvingsen said low back pain is long-lasting condition but — as noted in these theories — is not correctly treated.
“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,” Hartvigsen concluded.
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