654 Many back pain patients ‘getting wrong care’

Lower back pain is the leading cause of disability globally but too often patients are let down by the treatment they are offered, say experts. They have written a series of papers in The Lancet asking the worldwide medical profession to stop offering ineffective and potentially harmful treatments.

Strong drugs, injections and surgery are generally overkill, they say, with limited evidence that they help. Most back pain is best managed by keeping active, they advise.

Recommendations that doctors follow in the UK are clear about what investigations and treatment patients should expect. Some patients will require a scan to rule out underlying causes, but in most cases they are deemed unnecessary because they are likely to be inconclusive.

I – Word Understanding
Let down – disappointed
Overkill – excessive / too much

II – Have Your Say
1. Which of the following treatments are most commonly recommended by doctors and professionals in your country? What do you think about each treatment?
a. Surgery
b. Drugs / medicine / injection
c. Chinese medicine
d. Acupuncture / massage
e. Physical therapy
2. Here is a list of things experts say you should know about your back:
1) Your back is stronger than you may think – the spine is strong and not easily damaged, so in most instances the pain will be down to a simple sprain or strain
2) You rarely need a scan
3) Avoid bed rest and get moving (but avoid aggravating activities)
4) Do not fear bending or lifting – do it in a way that is comfortable, using the hips and knees
5) Remember that exercise and activity can reduce and prevent back pain
6) Painkillers will not speed up your recovery
7) Surgery is rarely needed
8) Get good quality sleep if you can, because it will help you feel better overall
9) You can have back pain without any damage or injury
10) If it doesn’t clear up, seek help but don’t worry – book an appointment to see your doctor or physiotherapist if the pain persists

654 Many back pain patients ‘getting wrong care’