Back pain being mismanaged, warn experts

The global burden of low back pain has reached 'tipping point' and action on prevention rather than treatment is needed, say experts.

Low back pain has been named the leading cause of disability worldwide, as experts accused doctors of letting down patients with the condition.

At any one time, 540 million people globally are affected by pain in the lower back that can be crippling and persist for months.

Most cases respond to simple physical and psychological therapies aimed at keeping people active and able to stay at work, according to a series of papers published in The Lancet.

Instead experts claim many back pain sufferers are wrongly being treated in hospital emergency departments, referred for scans or surgery, encouraged to rest and stop work, and prescribed powerful opioid pain killers.

Co-author, University of Sydney author Professor Chris Maher said millions of people across the world are getting the wrong care for low back pain.

"More care does not mean better care. More aggressive treatments for low back pain have little proven benefit and have the potential to make things significantly worse for patients," Professor Maher warned.

"Evidence suggests that low back pain should be managed in primary care, with the first line of treatment being education and advice to keep active and at work.

"However, in reality, a high proportion of patients worldwide are treated in emergency departments, encouraged to rest and stop work, are commonly referred for scans or surgery, or prescribed pain killers including opioids, which are discouraged for treating low back pain."

Leading a call to action on the serious public health issue, which is said to be at "tipping point", is lead author Professor Rachelle Buchbinder from Monash University.

She says instead of focusing on treatment and management, prevention must be a priority.

"We need to halt the continuing rise in back pain disability," said Professor Buchbinder.

"Back pain disability globally has increased by 54 per cent between 1990 and 2015 and its getting worse, and its getting worse due to the ageing population as well as the increased size of the population," said Prof Buchbinder.

The rheumatologist and epidemiologist is calling for public health programs that tackle obesity and low levels of physical activity to reduce the effects of low back pain on a person's daily life.

"Low back pain is just like the common cold and many people never go to the doctor they just manage it themselves. The problem is that it often recurs and a small group of people then have persisting chronic problems; and that's really where the disability comes in," explained Professor Buchbinder.

The good news is that a lot is known about what causes problems to persist, she said.

"We know disabling low back pain is over-represented in people with low-socio-economic status, lifestyle factors such as smoking, obesity and low levels of activity are all associated with the recurrence of low back pain; so those things are very important to address," said Prof Buchbinder.

Source AAP

Stay up to date with SBS NEWS

  • App
  • Subscribe
  • Follow
  • Listen
  • Watch