Most back pain ‘can’t be cured’, treatments waste of money: Study

If you’ve ever been to the doctor or a health professional with joint aches or back pains and they haven’t been able to assist you, there could be a reason for that.

New research published in the British Journal of Sports Medicine has found the majority of back pain patients experience doesn’t have an obvious cause, with lead researchers noting that doctors should stop offering scans and unproven treatments that give people the impression they can be cured.

Researchers Professor Peter O’Sullivan and Professor Jeremy Lewis argue that scans often detect changes such as spine disc degeneration that are used to explain the pain, but note they are also common in people without pain.

“It’s a myth that most persistent musculoskeletal pain with no obvious cause can be cured,” Professor Lewis told Starts at 60. “Doctors, physiotherapists and all healthcare professionals need to be a lot more honest with people presenting with non-traumatic and persistent musculoskeletal pain disorders about what they as health professionals can do for them and what management and outcomes the individual should really expect.”

He said because changes that often display in X-rays or scans are also seen in people that show no pain, it strongly suggests the symptoms or pain someone is experiencing isn’t actually coming from the observed changes.

Read more: Back pain sufferers receiving ‘harmful, ineffective’ treatments: Study

“This implies that many people will undergo surgery on structures, such as tendons, cartilage and bones that are not the cause of their symptoms,” Professor Lewis said. “Another example is when an individual is informed that the presenting symptoms relate to a weak core or poor posture, such as rounded shoulders or poking chin. Again, most of the evidence refutes claims made about specific postures being a cause of pain.”

When this happens, he noted many patients will wrongly believe their body is damaged or fragile and even avoid movement and activities or seek intervention to correct the problem.

“We contend that hundreds of thousands of people (if not more) around the world every year are having operations on tissues that are not the cause of their symptoms,” Professor Lewis explained. “It is the same for people getting treatments to improve their posture, manipulations to put their joints back into alignment, or improve their core stability for back pain, or receiving a large number of very often passive treatments that have been invented to cure their symptoms.”

He said people with a trauma, a history of cancer or those experiencing a loss or power or sensation in the legs should see a doctor or health professional to ensure nothing more serious is going on. He also said a scan wasn’t always the quick fix people thought it would be when it came to back health.

Read more: Dealing with back pain: What not to do

“What keeps backs healthy is movement, regular activity, good sleep habits and maintaining a healthy body weight. What is unhealthy for back is to avoid movement and activity and carrying too much body weight,” Professor Lewis said. “Don’t get a scan because everyone over 60 has degeneration … it’s like wrinkles on the inside and it’s a normal process of aging. “So make your keep your back mobile with gentle stretches and engage in regular exercise – the best exercise is the type you enjoy. Engage is healthy lifestyle.”

The authors also noted a reframe of the way non-traumatic persistent and disabling musculoskeletal pain conditions is cared for and treated is needed. Professor Lewis said strong clinical alliance, education, movement and strengthening of the painful region, regular physical activity, and lifestyle changes including sleep hygiene, quitting smoking and stress management can allow a person to build their confidence to take control and be responsible for their health. He added these were principles underpinning the management of other chronic conditions.

““For patients, creating an understanding and expectation that, as with other chronic health conditions, there is no magic cure for persistent and disabling musculoskeletal pain conditions is the key,” the authors added. “By doing this, we can be more honest with the level and type of care we can and should currently offer, and the outcomes that may be achieved.”

If you are experiencing back pain, it is always advised to see a doctor. Different conditions can impact the amount of movement and activity individuals can complete, so always talk to a health professional about the best plan for you. 

What do you think? Do you live with back pain? How do you manage your symptoms?