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Overtreatment of back pain: A nagging problem

Back pain is a common problem that affects at least 80 percent of us at some point in our lives.  It’s the second most common reason for see a doctor.  And when it comes to overtreatment, it may be number one.

We have a problem in this country when it comes to taking care of people with back pain.  Years of data show us that we over-scan, over-xray, and overtreat with medications and procedures. Not only is this costly, but it can harm people rather than help them.

The overtreatment of back pain includes excessive tests and treatments.  Some common issues include the following:

  • We do too many tests (e.g., back xrays, computerized tomography or CT scans and magnetic resonance imaging or MRI scans) particularly in people with back pain for less than six weeks. For about 90 percent of people, the back pain will go away within six weeks.
  • We over-prescribe expensive medications, like muscle relaxants and narcotics.  These medications are rarely necessary and may cause significant side-effects.
  • We do too many back surgeries and spinal injections on people with chronic back pain.

Meanwhile, the potential harm of overtreatment is very real.

With unnecessary tests, the greatest concerns are additional costs and false positive test results (that is, the test is “abnormal” but that abnormal result is wrong).  False positive results can cause needless anxiety.  In addition, they can lead to other tests or procedures that are unnecessary, expensive, and possibly risky.

With unnecessary back surgery and spinal injections, concerns include added cost and potential complications, which can be life threatening.

Consumers can take steps to protect themselves from becoming victims of overtreatment.  Here are some suggestions:

  • Ask questions.  For example, if your provider recommends an xray or scan, ask how they plan to use the test results.  If results won’t change the treatment plan, then why do the test?
  • Read and learn about back pain.  By doing your homework in advance, you know what to expect and are more prepared to ask questions.
  • If you have chronic back pain and surgery has been recommended, get a 2ndopinion.

Perhaps the best way to avoid overtreatment, is to have a healthy back.  And maintaining core muscle (back and abdomen) strength and flexibility is one way to go about this.  Strengthening the core muscles can prevent back pain.  It can also help people with chronic back pain.  So, embrace the health benefits of strengthening.

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