Over-Diagnosis of Back Pain Brings Harm Than Any Good!

Chiropractic care, ice, heat, and gentle exercise are evidently one of the best ways of treatment for back pain claim the latest news from Harvard Medical School. These conservative ways can beat the minute day treatment and diagnosis options that actually break the bank. They can end a culture of unnecessary tests, narcotics and surgery referrals adopted by most of the physicians.

Evident and Published Guidelines of Treating Back Pain Often Ignored

A study published in JAMA internal revealed that despite the fact conservative ways of initial treatment (physical therapy and medications such as ibuprofen and acetaminophen) of back pain is advised in most of the cases physicians often over-treat back pain. This is supported by abundant evidence and published guidelines. That is giving rise to imaging, narcotics and other physicians’ referrals.

Surgeons, specialists, pain clinics take this path of least resistance of primary care providers as a treasure stove. An $86 billion yearly is an estimated cost of back pain health care in the United States. An MRI imaging for any routine back pain it may not end up as routine. Patients referred for such surgery are 8 times more likely to face a surgery than patients treated with conservative means.

Time is required to understand patients’ assumptions regarding how conservative they want the treatment to be and how well it can be suited to their situation when they ask about off-guideline treatments for back pain. While physicians don’t seem to have much time for that says Dr. John Mafi.

A Worsening Trend of Overtreatment and Over-diagnosis of Back Pain

Harms of Screening:

There is potentially lower harm often associated with an abnormal screening test that is the risk of permanent harm. It can affect the participants for the rest of their lives instead of actually benefiting them. A study revealed there were men of 25% percent that were still worried about prostate cancer even after having a negative biopsy.

Rather than screening machine elevating the burden of worries and anxiety among patients. It extends patients to a neverending cycle of appointments and testing which were negative in the first place. When CT is used in lung cancer screening, positive findings are observed most of the time. While 96% of those positive are consequently found to be a false positive.

The research was conducted to observe how many times physicians acted against the guidelines of treatments. Patients with the age of 49 to 53 years were made part of this research. Among them, the ratio of female patients was 58 percent. The research was conducted for:

  • Imaging (X-ray, MRI, etc.)
  • Narcotics (opioids)
  • Referrals to physicians (spine specialists, pain specialists)

An evaluation of times was also conducted to observe how many physicians acted with ordering guidelines for following:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen
  • Referrals to physical therapy

Values were compared for years 1999-2000 versus 2009-2010:

  • NSAID or acetaminophen use significantly decreased. Starting from 36.9% in 1999-2000 ending to 24.5%
  • Narcotic use increased from 19.3% to 29.1%
  • Physical therapy referrals remained unchanged at 20%
  • Physician referrals increased from 6.8% to 14%
  • X-rays values remained unchanged at 17%
  • Computed tomograms or MRIs increased from 7.2% to 11.3%

No change was observed in physical therapy referrals. There was a total ratio of 20% of patients who were ever referred.

Conservative Ways to Cure Back Pain

1) Cold and Heat:

Start healing with ice or cold packets. Apply heat after 48 hours.

2) Rest:

If you experience any pain in a certain position i.e while sitting or standing. Go for bed rest. Do it for a limited period of time.

3) Exercise:

An acute flareup can be healed quickly by taking up an exercising program. That can help you with the chronic back pain and prevent other episodes of the pain. A doctor or a physical therapist can help you take a plan that is well suited to you.

4) Medication:

All that is usually needed to eliminate back pain are over the counter pain relievers (acetaminophen or an NSAID like aspirin), ibuprofen, or naproxen.

NOTE: Please don’t forget to consult your doctor before taking any medicine.

Are Results Getting any Better?

Substantial improvements among patients would have been a reason to justify the fact that Jumps in imaging, opioid prescriptions, injections, and fusion surgery is effective. Even treatment trials of patients using a combination of such procedures didn’t show complete recovery. Pain and dysfunctions were still reported in patients. There’s sparse of the amount of data on population-level related to back dysfunctions. Despite a rise in costs of spinal problems, a survey conducted by US Medical Expenditure Panel showed a worsening condition of functional limitations, mental health, working limitations or socio limitations in the present times than in 1997.