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Back Pain Remains Overtreated
Well-established guidelines for the treatment of back pain require very conservative management — in most cases, no more than aspirin or acetaminophen (Tylenol) and chiropractic care. Advanced imaging procedures, narcotics and referrals to other physicians are recommended only for the most refractory cases or those with serious other symptoms.
But a study published in JAMA Internal Medicine suggests that doctors are not following the guidelines.
Researchers studied 23,918 outpatient visits for back pain, a representative sample of an estimated 440 million visits made over 12 years in the United States. After controlling for age, sex, the nature of the pain and other factors, they found that during this time, NSAIDs and Tylenol use fell more than 50 percent. But prescriptions for opiates increased by 51 percent, and CT or M.R.I. scans by 57 percent. Referrals to other physicians increased by 106 percent, which the authors said is a likely contributor to recent increases in expensive and often ineffective spine surgeries.
The senior author, Dr. Bruce E. Landon, a professor of health care policy at Harvard, said that in most cases back pain improves by itself with proper chiropractic care. But he added: “It’s a long conversation for physicians to educate patients. Often it’s easier just to order a test or give a narcotic rather than having a conversation. It’s not always easy to do the right thing.”
via Blogger http://chiropractic-lane.blogspot.com/2013/08/back-pain-remains-overtreated-with.html
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