Is Back Pain Treatment Useless?
“Experts warn Back Pain treatment is useless…”
The Times, 22 March 2018 had a front page article about the current medical treatments for back pain:
Back pain is the world’s leading cause of disability. A series in ‘The Lancet’ medical journal stated it is routinely badly treated. In Britain, one in seven GP appointments is for muscle and nerve problems, mostly back pain. It reported that millions of people are receiving treatments of drugs, injections and surgery. This can make the problem a lot worse.
Doctors prefer to offer useless and often harmful treatments rather than tell patients that staying active, exercise and psychological therapy work for most cases of chronic back pain. Most people wrongly believe the myth that rest is best for the condition.
Patients understandably look for solutions and a cure. The reality is we don’t understand what causes the vast majority of back pain. A positive attitude and job satisfaction are among the strongest indicators of whether it will turn into a serious disability or not. The evidence underpinning invasive treatments is very weak. They can also cause harm. Studies show that a third of British patients are given opioid medication such as Tramadol and Morphine. However, the evidence is that they can make your pain worse and patients are becoming hooked and suffering dangerous side effects. So is conventional back pain treatment useless?
The value of early physical therapy
Several studies have investigated the effect of early intervention. Gelhorn et al (2012) found that those that received physical therapy in the first four weeks of their first recorded episode of back pain coped better long term. These had a significantly reduced likelihood of subsequent lumbar surgery, injections. Also fewer visits to a doctor over the following year compared to those that received physical therapy over three months from onset.
The fear associated with the pain can prevent a person feeling they can carry on with a normal daily routine. They get into a vicious circle of ‘not doing things’ to avoid pain. As an osteopath, I try to help patients find ways to cope and manage their pain. This is through gentle osteopathic treatment to get some initial ease, followed by supportive remedial exercises. I give advice about improving activity levels and lifestyle advice, with some help from over the counter medications if necessary, to build up their confidence and regain some control.