by Kimberly Allen, RN
Low back pain is one of the leading reasons for visits to primary care physicians with 1 out of every 10 visits being for low back pain at a cost of approximately $90 billion very year and that’s not counting the economic cost of lost productivity. Low back pain is second only to pain a significant public health concern.
Anyone that has ever suffered from chronic low back pain knows how much it can impact your quality of life. Unfortunately doctors today are more likely to make matters worse by ordering expensive scans and tests, prescribing narcotic pain relievers and in many cases referring you to very expensive specialists and spinal surgeons instead of following established guidelines for treatment of low back pain. in an article in JAMA Internal Medicine published in July the results of a survey of 24,000 office visits for back pain from 1999 to2010, for both acute and chronic pain. They found that doctors were prescribing the use of narcotic pain medicines instead of NSAID’s or acetaminophen much more often increasing from 19% in 1999 to 29% in 2010. During that time the use as well as the recommendation for use of non-narcotic medications declined from 37% of the time to approximately 24.5% in 2010. Along with the increase in narcotics came the increase in the number of CT scans and MRI’s which increased from 7% to approximately 11% between 1999 and 2010m and these tests aren’t cheap, they run upwards of $1000 each. Referrals to physicians specializing in back disorders and pain management doubled between 1999 and 2010. However, doctors aren’t solely to blame for the problem, The current health care system is to blame for most of the problem. In the current system doctors have very little time for office visits and on top of that they are not paid to advise and counsel you on how to properly manage your health. However, they are paid bonuses when given high marks by their patients in the satisfaction surveys. And how do the doctors get those high marks? By giving the patient what he/she wants of course. Which brings me to the other significant part of the problem. In today’s world of instant gratification everyone wants that quick fix. Why not? With today’s medical technology we can open arteries in the heart in about an hour without doing open heart surgery and there are now new medications that can bust a clot limiting the potential damage that can be done by a stroke. So what better way to get rid of that miserable back pain than with a good dose of narcotics. And because pain is a totally subjective symptom what better way to justify the need for those medications than getting some expensive tests that can verify there’s a problem.
The rising cost of treating back pain adds to the already sky rocketing health care costs and is an area with significant potential for saving while at the same time improving the quality of care. Although the out look for health care costs is grim there is some good news. According to Dr. Mafi, the lead author on the study, the vast majority of people with new-onset back pain will get better in 2-3 months with conservative treatment. So what is conservative treatment? Conservative treatment involves non-invasive therapies like physical therapy exercises and/or over the counter pain relievers. There are a wide variety of non-invasive, non-drug therapies available ranging from exercise programs that are specifically designed to meet an individuals needs to behavioral techniques like relaxation therapy and electrotherapy, the most common being transcutaneous electric nerve stimulation or TENS. In addition to the non-invasive therapy most doctors recommend the use of over the counter pain relievers like the NSAID’s ibuprofen or naproxyn as well as the cox-2 inhibitors like celebrex. If you are having severe muscle spasms, your doctor may recommend a muscle relaxant.
In today’s busy world of hustle and bustle, and you needed to have everything done or be somewhere 15 minutes ago the idea of spending 2-3 months letting your back heal is absolutely terrifying. However, the facts are that if you try to go too fast by taking strong pain medications to cover the symptom of pain so that you can continue to do the same thing that caused the problem in the first place the chances of your back healing are slim to none. The pain is a symptom that things aren’t the way they should be. Listen to it, don’t cover it up and try to move on without addressing the problem.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.