Treatment for lower back pain poor, harmful globally: Lancet

Current treatments including opioids, injections and surgery to treat lower back pain — the leading cause of disability globally — are useless, unnecessary and harmful, finds a series of studies in The Lancet. Globally, lower back pain affects more than 540 million people and the condition has doubled in the last 25 years.

The prevalence of the condition is expected to continue to increase with an ageing and increasingly obese population. Medical care with inappropriately high use of imaging, rest, opioids, spinal injections, and surgery is making the problem worse in both developed and developing countries, the findings showed.

"The burden from low back pain has reached a tipping point where the condition is growing rapidly, is poorly understood and is being mismanaged medically — at cost both to the patient and to the healthcare system," said Rachelle Buchbinder, Professor at the Monash University in Melbourne.

"Low-and middle-income countries are already emulating the low-value care that is endemic in high-income countries. "Across the globe (there is) inappropriately high use of imaging, rest, opioids, spinal injections and surgery. Doing more of the same will not reduce low back pain disability nor its long term consequences," Buchbinder said.

People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain.

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The researchers call for a coordinated international leadership to drive transformational change across health and social services and occupational settings to stop fragmented and outdated models of care. They also call for avoidance of the harmful and useless medical treatments through the adoption of a similar framework to drug regulation.

Public health campaigns need to address the widespread population and health professional misconceptions about the causes and prognosis of low back pain and the effectiveness of different treatments. IANS