Thousands of Australians dealing with lower back pain are being treated with “harmful procedures”, a study has found.
Leading researchers have called for urgent action, claiming the surgery, injections and dangerous opioid drugs that many patients are receiving may not be helping them at all – and could actually be causing more harm than good.
Writing in three papers, published in the Lancet medical journal, the group of 31 researchers calls on the government and health leaders to “tackle entrenched and counterproductive reimbursement strategies, vested interests, and financial and professional incentives that maintain the status quo”.
Disability due to back pain has risen by more than 50 per cent globally since 1990, the study explains. In fact, lead author Professor Rachelle Buchbinder said more than 3.7million Aussies suffer from lower back pain, costing billions to treat.
The papers state lower back pain as a whole is being mistreated on a global scale, and it’s now become a lucrative business for the industry – as “ineffective and potentially harmful approaches” are being taken.
“Low back pain is the leading worldwide cause of years lost to disability and its burden is growing alongside the increasing and ageing population,” the papers state.
Meanwhile, the team claims it’s difficult to determine a cause for lower back pain, and it can vary from patient to patient. They write: “For the vast majority of people with low back pain, it is currently not possible to accurately identify the specific nociceptive source.”
Psychological, social and economic factors can all play a part, and so can lifestyle choices such as smoking or obesity. MRI scans rarely help, the experts claim – as while they pick up physical abnormalities, these may not actually be the source of the pain, and could lead to unnecessary surgery.
Complex and expensive surgeries such as spinal fusion or addictive opioids are currently favoured, while cheaper treatments that could work are rarely prescribed to sufferers, the study says.
Inserting discs, fusing discs in the spine, or even being given spinal injections, may not actually help. Instead, cheaper, more natural treatments such as simple exercise therapy and psychology may have more chance of aiding patients, the experts claim.
Most back pain treatments are funded by Medicare, while exercises that have been proven to work, such as yoga, are not subsidised.
“We waste billions. People are being treated with too much of the wrong stuff and missing out on the right stuff,” Professor Chris Maher, co-author of a study which was published alongside the main research said, the Sydney Morning Herald reports.
“We have an industry that’s essentially allowed to do as it pleases in terms of marketing unproved products. People can make billions of dollars marketing something that’s unproven.”
Another author of the study, Professor Nadine Foster, added: “The papers are drawing attention to the rising levels of disability associated with back pain.”
She went on to slam the number of prescriptions for opioid pain relief drugs, saying: “Recent trials have shown they are not more effective than other much safer drugs, yet many patients are still being put on drugs that have opioids in them.”
However, some countries are beginning to take action – with Australia and the Netherlands reportedly looking at stopping funding for some invasive treatments.