Tuesday, June 8, 2010

Back Pain is Overtreated

A very interesting story by the Associated Press was released today highlighting a disturbing trend in treatment for back pain in the United States. Although the vast majority of acute back pain subsides after 4-6 weeks, Americans are receiving way too many tests (ex: MRI; X-Rays) for back pain, and opting for unproven and unwarranted surgeries. It is estimated that Americans spend up to $86 billion every year on health care costs for back pain.

This pattern of behaviour is quite consistent with other indicators of the quick-fix mentality that has become so prevalent in North America. Pharmacology sales (particularly mental health prescriptions) and surgeries for obesity are on the rise. Advances in modern technology allow for such improvements in health care, but there tend to be at least two problems with some of these approaches.

First, the health care costs are tremendous. Second, they do not always target the problem. There is a widespread assumption that back pain must be due solely to physical tissue damage, obesity is due to genetic and biological problems (or a lack moral character -- ex: laziness) , and mental health problems reflect problems with neurochemistry. Unfortunately, things are more complicated than this, and such uni-theoretical models are often inadequate to explain complex problems.

Thus, I was very happy to see a list of recommendations posted with this story. One of the recommendations listed is that Cognitive-Behavioural Therapy be included as part of treatment. This kind of recommendation, for the inclusion of a psychologist, is now standard practice in pain treatment. Unfortunately, I rarely see mention of this fact when I read about pain in the popular press.



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