Thursday, 22 March 2018

Billions wasted on ineffective low back pain treatments

Hundreds of thousands of Australian low back pain sufferers are being given harmful or useless treatments, resulting in billions of healthcare dollars being wasted, according to an editorial published in The Lancet today. Professor Rachelle Buchbinder, Head of our School’s Cabrini Epidemiology Unit, has led the charge on the call to action.

Thirty-one of the world’s leading back pain researchers joined Rachelle in highlighting how low back pain is being mistreated on an enormous scale. One in two Australians suffered from it in the past month; globally more than half a billion people were affected last year.

The condition is the leading worldwide cause of years lost to disability and its burden is growing alongside the increasing and ageing population. The group drew attention to the fact that these population shifts are more rapid in low-income and middle-income countries, where adequate resources to address the problem might not exist.

Doctors regularly prescribe addictive opioids and potentially harmful treatments including spinal fusion surgery, despite there being little evidence these treatments work. Meanwhile, cheap treatments that do work are rarely prescribed.

“The elephant in the room is vested interests - among industry but also clinicians. Clinicians want to do the best for their patients. But they often believe in treatments even when the evidence shows they don’t work.” says Professor Rachelle Buchbinder.

Nearly all cases have no specific cause. However, obesity, sedentary lifestyle and employment involving heavy labour are known risk factors.

Medicare funded low back pain treatments cost taxpayers about $4.8 billion a year, despite there being little evidence for many.

The best treatments are often the cheapest: exercise therapy and psychology. Above all, simply staying active when your back hurts is effective.

“Low back pain is like the common cold – it should just be considered a part of everyday life,” says Professor Buchbinder. “Most people with back pain, it gets better very quickly whatever you do.”

Adapted from a Sydney Morning Herald article accessed 22 March 2018: