Worrisome Trends in Back Pain Management
The title of this blog is the same title of an article published on Medscape (a medical publishing website) back in 2013. I am using this title again since the author's emphasis on the article has become increasingly prevalent over the past 9 years.
The article began "In contrast to clinical practice guidelines, specific therapeutic approaches to the treatment of back pain have increased significantly over a recent 12-year period, new research shows."
Specifically, investigators at Harvard Medical School in Boston, Massachusetts, found a 106% increase in the number of referrals to other physicians, some presumably for surgery; a 56.9% increase in advanced imaging; and a 50.8% increase in the use of narcotics....."
"The investigators also found that referrals to other physicians represented the biggest increase over the years, going from 6.8% to 14.0% (P< .001). Primary care doctors made up the bulk of those making these referrals, presumably to specialists such as orthopedic surgeons.
This, said Dr. Malfi (the lead researcher), is a "worrisome trend" because there's LITTLE PROOF THAT BACK PAIN SURGERY, such as lumbar fusion, ACTUALLY WORKS. In addition, it's costly and can be life-threatening.
The increase in referrals was an escalation in the use of MRI or computed tomography (CT): from 7.2% to 11.3% (P, .001). Research shows that imaging in the acute care setting provides neither clinical nor psychological benefits to patients with routine back pain.
The overuse of imaging is almost certainly related to the significant increase in spine operations over the last decade, the authors note."
This article was published in July 0f 2013. Since then, the rate of diagnostic imaging (MRI) usage, leading to surgical intervention, has increased considerably. Unfortunately, Allegheny County has the highest density of orthopedics and neurosurgeons in the world. Our surgical clinicians perform more spinal surgeries per capita than anywhere else in the world. Mind you, this is not something we want to be #1 in. Almost as a cruel irony, none of the healthcare systems in Allegheny County are ranked in the Top 20 nationally when it comes to spinal surgery outcomes.
So, before you have that surgical procedure for the herniated disc, canal stenosis, or unrelenting sciatica, try the conservative approach to back pain by contacting us to find out about our Advanced Disc Rehydration Protocol that works on fixing the CAUSE, not the EFFECT.
107 Gamma Drive Suite 100