Are Doctors Getting Worse at Treating Back Pain?

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back-pain-ct-scanDid you know that 1 in 10 primary care visits are due to back pain? Nearly 65 million Americans suffer from back pain, and one of the first places they turn to is their doctor. Unfortunately, doctors aren’t living up to their expectations when it comes to diagnosing and treating this type of pain. Expensive scans may be ordered and narcotic prescriptions written, but these treatments do little to help the pain, and in some cases, make it worse.

How do we know for fact that doctors are getting worse at treating cases of back pain? Researchers at Beth Israel Deaconess Medical Center in Boston reviewed records of nearly 24,000 doctor visits for back pain between 1999 and 2010. Acetaminophen and NSAIDs have been prescribed less, while opioids have been prescribed more. Not only do opioids like OxyContin have a high risk for addiction, but also they have been shown to have very little effect, if any, on treating pain in the back.

It’s not just pain medication that doctors are quick to prescribe but costly tests as well. Scans have risen from 7 to 11 percent in the past decade, and the most commonly requested tests include MRI and CT scans. Since these tests are noninvasive, doctors feel that there is nothing wrong with requesting them, especially if it helps put the patient’s mind at ease. Unfortunately, these scans don’t help much.

Of course, money is always at the center of the debate. Medical tests are expensive, and doctors are more likely to request scans when they have the imaging equipment at their office. Also, doctors are rated online for the world to see, so it’s important for medical professionals to please the patient. If that means prescribing OxyContin for three months instead of ibuprofen, some doctors will do it.

There has been a lot of conflict as to how to most effectively treat back pain, and this can be in part because it can stem from a number of sources. But clearly there needs to be careful assessment of the soft tissue and musculoskeletal structure before we resort to expensive scans, addictive pain pills, and surgery.

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