An article published in the medical journal, The Lancet, suggests that chronic back pain, which is the world’s leading cause of disability, is invariably badly treated.
The article, which is authored by an international group of researchers, says that patients are routinely prescribed drugs (often opioids) and undergo injections and surgery, all of which are pointless.
The authors say that doctors seem to prefer offering patients useless and sometimes harmful treatments instead of telling their patients that there is nothing that can usefully be done for them in the long term except staying active and undergoing psychological therapy. Too many people, they say, believe the ‘myth’ that ‘rest is best’ for a bad back.
Despite evidence that job satisfaction and a positive attitude are the strongest factors in determining whether back pain will become a serious disability, they suggest that doctors are usually reluctant to discuss social and psychological issues, instead preferring to refer people immediately for scans, which is the start of the chronification process.
Focus on obesity and physical activity
The lead author, Professor Rachelle Buchbinder, a rheumatologist and epidemiologist at Monash University in Australia, says that the focus should be prevention rather than treatment and management. “Back pain disability globally has increased by 54 per cent between 1990 and 2015 and it’s getting worse and it’s getting worse due to the ageing population as well as the increased size of the population,” says Professor Buchbinder. The way forward, she argues, is to focus on tackling obesity and increasing levels of physical activity.
Understandably, the article is expected to provoke considerable controversy and debate, not only among sufferers of chronic back pain, but among the wider medical community.
Worldwide, the treatment of back pain is a huge business and many treatment providers will no doubt point to numerous patients that, on the face of it, have responded well to a variety of treatment, invasive and otherwise.