Should Back Pain Sufferers Avoid Medical Care?

Should Back Pain Sufferers Avoid Medical Care? This question was asked in a recent edition of The Back Letter. With a title like that, I couldn’t help but read the article. The answer according to an editorial in The Journal of the American Medical Association is a resounding ‘yes’; it seems that avoiding medical care is better for you. After countless studies into evidence-based care for spinal problems it has become glaringly apparent that your average MD has no real clue as to how to treat these common but often debilitating spinal aches and pains, except by ineffective and unscientific means.

So, if you want your back pain to get worse, or if you want to miss weeks of playing your favorite sport or a lot of work, or if you want to risk increased disease and even death from dangerous, unnecessary drugs, then no, the average back or neck pain sufferer should not become a medical patient. To quote the Letter article, “There is undeniable historical evidence that the medical community has managed back pain over the years in a fashion that has often encouraged symptom magnification, chronicity, and workplace disability.”

Back pain now affects so many people in the industrial world that it has become a real crisis. In the US, $50 billion dollars is spent on lower back pain alone. This is a staggering amount of money, which when combined with neck pain and the bills from Europe, Scandinavia, Canada, and Australia would probably support several third-world countries. It is for this reason as well that more and more individuals in the medical field are suggesting that people begin to find better ways to treat their spines. Clearly, the current pathways are not getting us out of the woods.

Another two studies have served to underline these thoughts. One study showed that patients with acute lower back pain were getting way too many MRI’s and all that was doing was adding to the costs and increasing the surgery rates. The other article discussed the fact that almost 20% of back patients who showed up at an ER got needless x-rays, sometimes scads of them. It seems that this big ship has no rudder.

Many within the medical community are calling out for change, but it doesn’t appear to be having much effect as yet. A pilot study in Australia and one in Scotland was designed to educate both patients and doctors on how to manage back pain; i.e. what drugs to use, how much rest to get, when to return to work/sports, etc. The projects were small and very regional, and they had to be designed not to put down the usual care methods, but rather to introduce a modicum of evidence-based thinking. Both projects, in themselves, were successful and both pointed out strongly that a massive re-education is required to erase generations of false notions and dangerous medical practices.