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Are doctors treating back pain correctly?

Back pain is a problem that many people face. Reportedly, over 10 percent of primary-care physician visits by patients are related to back pain. In addition to being a very common medical problem, back pain can also be a very impactful one. Such pain can limit or knock out a person's ability to work and can have other serious effects on a person's life.

Given the severe impacts back pain can have on its victims, one would hope that doctors would make sure to act properly when it comes to the treatment of back pain. Unfortunately, a recent study indicates that doctors may not always be using the right forms of treatment when treating back pain. The study indicates that doctors may be turning too quickly to aggressive forms of treatment rather than following the treatment guidelines laid out by the American College of Physicians.

The American College of Physicians guidelines recommend that the first line of treatment for most forms of back pain should be over-the-counter pain medications and physical therapy, with narcotic pain medications and imaging scanning only being used as a starting treatment in rare instances.

The study indicates that, over the past several years, use of the treatments recommended under the guidelines has held steady or dropped while use of the "rare-instances" treatments has increased.

In the study, researchers looked at survey data that regarded around 24,000 back-pain-related doctor visits. The visits in question occurred during a period spanning from 1999 to 2010. The researchers looked at what treatment methods doctors used during these visits.

The researchers found that, between 1999 and 2010, use of the recommended over-the-counter drugs dropped about 12 and a half percentage points while use of physical therapy held steady. Meanwhile, researchers found that use of narcotic pain medications rose about 10 percentage points and use of CT scans, MRI scans and similar scans rose about 4 percentage points over this time period.

The study's results give rise to some important questions. Why are physicians increasingly deviating from the guidelines regarding the treatment of back pain? What impacts is this deviation having on patients? Is it leading to patients facing increased medical costs? Is it impacting the ability of patients to manage/recover from back pain? One wonders what the answers to these questions will ultimately be determined to be.

Source: KSDK, "Back pain often treated with wrong treatment," Nanci Hellmich, July 29, 2013

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