The Ineffective Treatment of Back Pain - By Brent Dodge

An article was recently published on the popular NPR Health Blog entitled “Doctors Increasingly Ignore Evidence in Treating Back Pain.” This article was posted and reposted on social media sites. Why the interest? It is simple – because millions of American live with back pain. Many of them just take it and think that back pain is part of their life.  Some report it to their primary care physician. If they are lucky, their physician reads about and more importantly acts based on the evidence for treating back pain. Unfortunately, this is not often the case. More often than not, the patient is given medications to mask the pain or sent for a costly MRI or CT scan.

• The recent blog post from NPR reveals this truth with startling statistics. Several parts of this article are disturbing. Not only are doctors getting worse at prescribing scientifically based treatment for back pain, but they are also exposing their patients to increasingly strong and addictive medications.

While use of the weaker over the counter pain killers has decreased, prescriptions for OxyContin have significantly increased. Add that to the fact that many of the individuals receiving these prescriptions for strong Opiods have a history of substance abuse, and we are faced with a terrible health care disaster.

• These strong pain killers do not solve the problem; they just temporarily cover it up. It would be like putting a big bandage on a festering wound. When the wound gets bigger, so does the bandage or the dosage of medication in the case of back pain. No one cleans the wound or tries to solve the source of the problem, they just cover it up and hope that it goes away. Does that make any sense? Of course not.

Often a costly scan, such as an MRI or CT scan will be ordered in attempt to find the ‘cause’ of the back pain but more often than not these scans are inconclusive.

• As health care providers, we should know when these scans are necessary. And it’s important to take cost into consideration. We should treat the symptoms, not the scan results. When the scan is inconclusive, the patient in turn gets frustrated looking for an answer and often turns to more medications. The problem compounds itself and the patient goes further and further into debt without ever getting any actual treatment, only scans and meds.

At the conclusion of the article posted by NPR is perhaps is the most disturbing ‘fact’. “Doctors should cut a little slack,” a journal commentary accompanying this study says, “because guidelines have been conflicted on back pain treatment until recently, and it takes 17 years, on average, for new treatment standards to be widely adopted.”

17 years. Does it really have to take that long? The evidence on the effectiveness of physical therapy in the treatment of back pain has become increasingly strong over the past decade. It is such a simple choice. Do you give someone with an addictive personality more drugs or send them to a place where perhaps they can be taught to care for themselves. As a patient do you just accept that back pain is a part of your life. Do you give up on physical therapy because it did not work for you 5 or 10 years ago?

I encourage you to be an active participant in health care decisions and your recovery. It’s important that when possible these medications be limited and ensure sound scientific evidence is used in the decisions that determine our health and wellness.
​
For more information on Alpine’s approach to spine care, we encourage you to visit our clinic website by clicking here.